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COMMENTS & OPINIONS
What If Chlorthalidone-Associated Hyperglycemia Develops?—Reply
Joshua I. Barzilay, MD;
Jeffrey A. Cutler, MD, MPH;
Barry R. Davis, MD, PhD;
Sara L. Pressel, MS;
Paul K. Whelton, MD, MSc;
Jan Basile, MD;
Karen L. Margolis, MD, MPH;
Stephen T. Ong, MD;
Laurie S. Sadler, MD;
John Summerson, MS; for the ALLHAT Collaborative Research Group
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In reply
Silver asks what one should do if FG levels rise into the diabetic range during hypertension therapy with diuretic use. To answer this question, one should put the ALLHAT diuretic-associated diabetes results into perspective. First, the 4-year cumulative incidence of new-onset diabetes was 11.0% with chlorthalidone, 9.3% with amlodipine, and 7.8% with lisinopril therapy. If amlodipine is assumed to be metabolically neutral, then 85% (9.3/11.0) of diabetes cases associated with diuretic use is not induced by a diuretic. Second, the differences in glucose levels between chlorthalidone and amlodipine (1.5 mg/dL) and lisinopril (4.0 mg/dL) at year 4 are sufficiently small . . . [Full Text of this Article]
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RELATED LETTER
What If Chlorthalidone-Associated Hyperglycemia Develops?
Alan Silver
Arch Intern Med. 2007;167(13):1434.
EXTRACT
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RELATED ARTICLE
Fasting Glucose Levels and Incident Diabetes Mellitus in Older Nondiabetic Adults Randomized to Receive 3 Different Classes of Antihypertensive Treatment: A Report From the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)
Joshua I. Barzilay, Barry R. Davis, Jeffrey A. Cutler, Sara L. Pressel, Paul K. Whelton, Jan Basile, Karen L. Margolis, Stephen T. Ong, Laurie S. Sadler, John Summerson, and for the ALLHAT Collaborative Research Group
Arch Intern Med. 2006;166(20):2191-2201.
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