The study by Barzilay et al1 reconfirms that thiazide-like diuretics are associated with an increased risk of new-onset diabetes compared with other antihypertensive agents and that incident diabetes is associated with increased risk of all cardiovascular events and significantly so for coronary heart disease. However the authors of these analyses suggest that diuretic-associated incident diabetes may be “innocent.” If true, this would be a surprising observation with important clinical implications and therefore merits careful examination.
Gupta AK, Poulter NR. Antihypertensive-Associated Incident Diabetes: Controversy Persists. Arch Intern Med. 2007;167(13):1433. doi:10.1001/archinte.167.13.1433-a