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What is the best blood pressure medicine for people with diabetes?

By Robert Ehrman, MD, Reviewed by Staci Gulbin, MS, MEd, RD, LDN and Martha Funnell

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Many medicines are used to treat high blood pressure, and they all work differently. One type of blood pressure medicine is called ACE inhibitors. This type of medicine can help to prevent damage to the kidneys, and so it is a good choice for a person with diabetes. ACE inhibitors make it easier for your heart to work. They block chemicals that narrow blood vessels and this can help slow down the damage to the kidneys that high blood glucose causes.

What does the research show?

Researchers wanted to find out if ACE Inhibitors were better for people with diabetes than some other high blood pressure medicines.  They wanted to see if taking an ACE inhibitor could:

  • Protect the kidneys (if taken for many years).
  • Decrease the number of people who need dialysis.
  • Reduce the number of people dying.

To find the answer, they looked at the medicines taken by more than 36,000 people with diabetes. They also looked at blood test results that checked kidney function, the number of people who needed to start dialysis, and the number of people who died during the study.

This research study found that:

  • ACE Inhibitors slow down the damage to the kidneys of people with diabetes.
  • No type of blood pressure medicine (or combo of medications) changed the number of people who needed dialysis.
  • If more than one medicine is needed to control blood pressure, taking an ACE Inhibitor plus a calcium-channel blocker is a very good mix.
  • Taking beta-blockers (another type of blood pressure medicine) might increase the risk of death in patients with diabetes.

Some of those results sound scary, so what do they mean?

Research results can be very helpful, but can also be scary to hear. The study discussed above said that taking beta-blockers might increase the risk of death in people with diabetes. Does this mean you should stop taking your beta-blocker? No! There are many reasons to take a beta-blocker, such as an allergy to other medicines, the need to keep blood pressure in the target range, or to treat health problems other than high blood pressure.

Always talk to your healthcare professional or pharmacist if you have questions about your medicines, and never stop taking a medicine prescribed to you without talking to someone first.

What is the best blood pressure medicine for people with diabetes?

This research shows that ACE Inhibitors can help protect the kidneys of people who have diabetes, so it is usually the first medicine prescribed.  The main side effect for ACE inhibitors is a cough.

The study also suggests that beta-blockers might not be the best medicine for some people with diabetes. And, if more than one medicine is needed to treat high blood pressure, taking a calcium-channel blocker along with an ACE Inhibitor is good for some people with diabetes.

Always talk to your healthcare team first if you have any questions about your medicines. and never start or stop a medicine without their advice.

 

 

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