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A1C Control Not Compromised by Antihypertension Drug Combo

A fixed-dose combination of trandolapril and verapamil SR—abbreviated as T/V—can effectively treat hypertension while remaining neutral to glucose control, according to a study reported at the annual meeting of the American Society of Hypertension (ASH), held May 19–22 in Chicago. The study compared the T/V combination with a combination of losartan and hydrochlorothiazide (L/H).

Previous results from the Study of Trandolapril/Verapamil SR and Insulin Resistance (STAR) study revealed that the fixed-dose T/V combination is metabolically neutral, while the L/H combination worsened glycemic control and increased the risk of new-onset diabetes.¹

At the ASH meeting, George Bakris, MD, of University of Chicago, presented data from the STAR 6-month follow-up (STAR-LET), which provided a longer follow-up for T/V in people with metabolic syndrome and determined the glucosetolerance effects of switching participants from L/H to T/V therapy.

After 6 months of treatment with T/V, those who previously had been given L/H showed significantly improved glycemic control. Participants who remained on T/V during the entire study period had no change in glycemic control. "Overall, the blood pressure effect over the study period was not significantly different between groups," Bakris says.

Bakris finds the STAR-LET results encouraging, given that managing hypertension in people at risk of diabetes can be particularly challenging. Thiazide diuretics and beta-blockers are linked to worsening glycemic control. Some research suggests that angiotensin-converting enzyme inhibitors might improve glycemic control, but long-term therapy failed to show significant effects in the Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication (DREAM) trial (DOC News, November 2006, page 1).

The STAR-LET results suggest that impairment of glycemic control after 1 year of diuretic therapy can be reversed by switching to treatment that does not involve a thiazide drug, Bakris says.

References

1. Bakris G, Molitch M, Hewkin A, et al.: Differences in glucose tolerance between fixed-dose antihypertensive drug combinations in people with metabolic syndrome. Diabetes Care 29: 2592–2597, 2006.[Abstract/Free Full Text]

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Services Email this article to a friend Similar articles in this journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Goldfarb, B. Search for Related Content PubMed Articles by Goldfarb, B. Social Bookmarking                What's this?