{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T12:49:05Z","timestamp":1785242945128,"version":"3.55.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2013,5,20]]},"abstract":"\n Background<\/jats:title>\n \n We aimed to determine how single and combination antihypertensive therapy alters risk for diabetes mellitus (\n DM<\/jats:styled-content>\n ).Thiazide diuretics (\n TD<\/jats:styled-content>\n ), \u03b2 blockers (\n BB<\/jats:styled-content>\n ), and renin\u2013angiotensin system blockers (\n RASB<\/jats:styled-content>\n ) impact\n DM<\/jats:styled-content>\n risk while calcium channel blockers (\n CCB<\/jats:styled-content>\n ) are neutral.\n DM<\/jats:styled-content>\n risk associated with combinations is unclear.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We enrolled nondiabetic patients from\n K<\/jats:styled-content>\n aiser\n P<\/jats:styled-content>\n ermanente\n N<\/jats:styled-content>\n orthwest with a fasting plasma glucose (\n FPG<\/jats:styled-content>\n ) <126\u00a0mg\/dL between 1997 and 2010.\n DM<\/jats:styled-content>\n cases were defined by a\n FPG<\/jats:styled-content>\n \u2265126\u00a0mg\/dL, random plasma glucose \u2265200\u00a0mg\/dL, HbA\n 1c<\/jats:sub>\n \u22657.0%, or new\n DM<\/jats:styled-content>\n prescription (index date). We used incidence density sampling to match 10 controls per case on the date of follow\u2010up glucose test (to reduce detection bias), in addition to age and date of cohort entry. Exposure to antihypertensive class was assessed during the 30\u00a0days prior to index date. Our cohort contained 134\u00a0967 patients and had 412\u00a0604 glucose tests eligible for matching. A total of 9097\n DM<\/jats:styled-content>\n cases were matched to 90\u00a0495 controls (median age 51\u00a0years). Exposure to\n TD<\/jats:styled-content>\n (\n OR<\/jats:styled-content>\n 1.54, 95%\n CI<\/jats:styled-content>\n 1.41 to 1.68) or\n BB<\/jats:styled-content>\n (\n OR<\/jats:styled-content>\n 1.19, 95%\n CI<\/jats:styled-content>\n 1.11 to 1.28) was associated with an increased\n DM<\/jats:styled-content>\n risk, while\n CCB<\/jats:styled-content>\n and\n RASB<\/jats:styled-content>\n exposure was not.\n TD<\/jats:styled-content>\n +\n BB<\/jats:styled-content>\n combination resulted in the fully combined diabetogenic risk of both agents (\n OR<\/jats:styled-content>\n 1.99, 95%\n CI<\/jats:styled-content>\n 1.80 to 2.20; interaction\n OR<\/jats:styled-content>\n 1.09, 95%\n CI<\/jats:styled-content>\n 0.97 to 1.22). In contrast, combination of\n RASB<\/jats:styled-content>\n with either\n TD<\/jats:styled-content>\n or\n BB<\/jats:styled-content>\n showed significant negative interactions, resulting in a smaller\n DM<\/jats:styled-content>\n risk than\n TD<\/jats:styled-content>\n or\n BB<\/jats:styled-content>\n monotherapy.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Diabetogenic potential of combination therapy should be considered when prescribing antihypertensive therapy.<\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.113.000125","type":"journal-article","created":{"date-parts":[[2013,6,11]],"date-time":"2013-06-11T03:33:28Z","timestamp":1370921608000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Antihypertensive Drug Class Interactions and Risk for Incident Diabetes: A Nested Case\u2013Control Study"],"prefix":"10.1161","volume":"2","author":[{"given":"Rhonda M.","family":"Cooper\u2010DeHoff","sequence":"first","affiliation":[{"name":"Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL"},{"name":"Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven T.","family":"Bird","sequence":"additional","affiliation":[{"name":"Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research, Office of Surveillance and Epidemiology, Department of Epidemiology, Silver Spring, MD"},{"name":"Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory A.","family":"Nichols","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Center for Health Research, Portland, OR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A.","family":"Delaney","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL"},{"name":"Department of Epidemiology, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almut G.","family":"Winterstein","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL"},{"name":"Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-9017"},{"key":"e_1_3_4_3_2","volume-title":"National Diabetes Fact Sheet: National Estimates and General Information on Diabetes and Prediabetes in the United States, 2011","author":"Centers for Disease Control and Prevention","year":"2011","unstructured":"Centers for Disease Control and Prevention . 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Characteristics associated with poor glycemic control among adults with self\u2010reported diagnosed diabetes\u2014National Health and Nutrition Examination Survey, United States, 2007\u20132010. Morb Mortal Wkly Rep. 2012;61:32\u201337.","journal-title":"Morb Mortal Wkly Rep"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.113.000125","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:00:00Z","timestamp":1715594400000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.113.000125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,5,20]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2013,5,20]]}},"alternative-id":["10.1161\/JAHA.113.000125"],"URL":"https:\/\/doi.org\/10.1161\/jaha.113.000125","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,5,20]]},"assertion":[{"value":"2013-02-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-05-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-06-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e000125"}}