β-blockers and diuretics in the treatment of hypertension: 'A friendly fire?

In a recent issue of High Blood Pressure and Cardiovascular Prevention, a very interesting debate on the clinical and prognostic significance of new-onset diabetes mellitus in hypertension was held by Prof. M.H. Alderman and Prof. P. Verdecchia. Beside the major objectives of the debate, both authors included in their discussion references to the potential influence of antihypertensive treatments on susceptibility to diabetes development. Indeed, in the last few years, especially after the introduction of this treatment as a secondary or additive endpoint in interventional clinical trials on hypertension, new-onset diabetes has raised the interest of physicians, and actually represents a 'hot topic' in the global cardiovascular risk profile and consequent therapeutic management in hypertension. The following editorial provides some element of discussion. Obviously, it cannot be conclusive, although it may stimulate active and direct investigation on this aspect, which can have a major influence on healthcare systems expenditure, given the uprising prevalence of hypertension and the mounting prognostic importance of diabetes in the adult and elderly hypertensive population. © 2008 Adis Data Information BV. All rights reserved.