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NDT Advance Access originally published online on August 7, 2008
Nephrology Dialysis Transplantation 2008 23(11):3389-3391; doi:10.1093/ndt/gfn455
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


The choice of antihypertensive therapy in patients with the metabolic syndrome—time to change recommendations?*

Karl F. Hilgers1 and Johannes F. E. Mann2

1 Department of Nephrology and Hypertension, University of Erlangen-Nürnberg 2 Department of Medicine VI, Schwabing General Hospital, Ludwig-Maximilians-University of Munich, Germany

Correspondence and offprint requests to: Karl F. Hilgers, Nephrology Research Laboratory, Loschgestrasse, 891054 Erlangen, Germany. Tel: +49-9131/853-6214; Fax: +49-9131/853-5821; E-mail: karl.hilgers@uk-erlagen.de

Keywords: ACE inhibitors; diabetes; hypertension; thiazides

The first 150 words of the full text of this article appear below.

Patients with hypertension and the metabolic syndrome have high risk of suffering from future cardiovascular and kidney disease. There are no large-scale, randomized trials to establish the antihypertensive drug of choice for this important group of patients, but several authors consider angiotensin converting enzyme inhibitors (ACEI) as preferable, calcium channel blockers as intermediate, and beta-blockers as well as thiazide diuretics as less well suited (see for example the latest guidelines of the European Society of Hypertension [1]). This notion is primarily based on the metabolic side effects of thiazides and beta-blockers that may increase blood lipids and glucose, relative to ACEI and CCB [2]. Beta-blockers also promote weight gain, and both thiazides and beta-blockers are associated with an increased incidence of diabetes, compared to CCB and ACEI [3].

Wright et al. [4] have recently published a subgroup analysis of the ALLHAT . . . [Full Text of this Article]


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