Sabu Sneha M, Seshadri Shubha, Thunga Girish, Poojari Pooja G, Acharya Leelavathi D
Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Department of Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
J Pharm Bioallied Sci. 2020 Jan-Mar;12(1):48-56. doi: 10.4103/jpbs.JPBS_168_19. Epub 2020 Jan 29.
The objective of this study was to determine the association between antihypertensive drug use and new-onset diabetes (NOD) in patients with hypertension (HTN).
A retrospective observational study was conducted in a tertiary care hospital located in south India. Patients diagnosed with HTN and HTN with diabetes between January 2012 and December 2016, were identified and studied. Medical records of these patients from Medical Record Department were evaluated by medical record review method, and relevant data were recorded in a case record form. Statistical evaluation by chi-square method and odds ratio (OR) was carried out to appraise the incidence of NOD in patients taking antihypertensive medications.
A total of 1250 patients with HTN were screened, and based on inclusion and exclusion criteria, 952 patients were enrolled in the study; among which, 537 were patients with HTN and 415 were patients with diabetic HTN. The majority of the patients with HTN and patients with diabetic HTN were from the age-group of above 60 years. The most commonly prescribed drugs observed in our study population were amlodipine in 94 (22.7%) patients. OR was calculated and it was observed that the combination therapy has a fivefold risk for the development of NOD in patients with HTN, followed by Angiotensin II receptor blockers (2.06) (confidence interval [CI]: 1.56-2.73), diuretics (1.33) (CI: 0.95-1.85), non-Dihydropyridine calcium channel blockers (DHP CCBs) (1.3) (CI: 0.51-3.30), vasodilators (1.13) (CI: 0.40-3.15), and Angiotensin converting enzyme inhibitors (1.06) (0.68-1.64).
Patients on non-DHP CCBs, diuretics, and combination antihypertensives showed more chances of developing NOD.
本研究的目的是确定高血压（HTN）患者使用抗高血压药物与新发糖尿病（NOD）之间的关联。
在印度南部的一家三级护理医院进行了一项回顾性观察研究。确定并研究了2012年1月至2016年12月期间诊断为高血压和高血压合并糖尿病的患者。通过病历审查方法对这些患者来自病历科的病历进行评估，并将相关数据记录在病例记录表中。采用卡方检验和比值比（OR）进行统计评估，以评估服用抗高血压药物患者的NOD发生率。
共筛查了1250例高血压患者，根据纳入和排除标准，952例患者纳入研究；其中，537例为高血压患者，415例为糖尿病高血压患者。大多数高血压患者和糖尿病高血压患者来自60岁以上年龄组。在我们的研究人群中观察到最常用的药物是氨氯地平，有94例（22.7%）患者使用。计算了OR，观察到联合治疗使高血压患者发生NOD的风险增加五倍，其次是血管紧张素II受体阻滞剂（2.06）（置信区间[CI]：1.56 - 2.73）、利尿剂（1.33）（CI：0.95 - 1.85）、非二氢吡啶类钙通道阻滞剂（DHP CCBs）（1.3）（CI：0.51 - 3.30）、血管扩张剂（1.13）（CI：0.40 - 3.15）和血管紧张素转换酶抑制剂（1.06）（0.68 - 1.64）。
使用非DHP CCBs、利尿剂和联合抗高血压药物的患者发生NOD的机会更多。
