An overview of the effects of combination therapy with a renin-angiotensin system blocker plus a calcium channel blocker on glucose homeostasis in non-diabetic hypertensive patients

Arterial hypertension (AH) is a major cardiovascular risk factor and often coexists with insulin resistance. Insulin resistance impairs glucose homeostasis has been associated the development of new-onset type 2 diabetes mellitus (T2D). Overactivity renin-angiotensin system (RAS) mediated by angiotensin II adversely affects homeostasis. The blockade RAS use converting enzyme inhibitors (ACEi) or receptor blockers (ARBs) beneficial effects on metabolism. On other hand, calcium channel (CCBs) have reported to exert metabolic neutral effect. By contrast, diuretics beta-blockers shown an overall negative effect Current ESH/ESC treatment guidelines recommend fixed single-pill combinations either CCBs thiazide/thiazide-like in hypertensive patients grade 1 AH high risk, greater. Nonetheless, considering patient’s medical history comorbidities, antihypertensive should be carefully tailored. To this, at developing T2D, impaired fasting (IFG) tolerance (IGT), preferentially treated monotherapy combined using agents which do not affect worsen