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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Antihypertensives and new onset diabetes

PharmaTimes has reported [Registration required] "amlodipine cuts new diabetes risk by 34%". The headline is derived from a clinical trial update that examined new onset diabetes in the ASCOT-BPLA trial. The update was presented at the 2006 World Congress of Cardiology.

The Blood Pressure Lowering Arm of the ASCOT Study was main reason for the review of the NICE Hypertension Guidelines. However, focussing solely upon one aspect of the trial results is inappropriate and could prove dangerous.

At the same event, it was reported that patients with acute coronary syndrome have a much lower mortality and morbidity if they continue to take beta-blockers. After just 6 months mortality rates increase from 0.4% in those taking beta-blockers to 20.2% in those who were not taking beta-blockers. Clearly, beta-blockers still have a useful place in some patients.

Action: This update provides a useful reminder that clinicians should be following the NICE Hypertension Guideline for patients with uncomplicated hypertension. Patients with diabetes or acute coronary syndrome should be treated after due consideration of their other morbidities.

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