This week we have an interesting post-hoc article on the results of the Da Qing Diabetes study. This retrospective examination looks at how hypertension increases the risk for diabetes and how that in turn increases the risk for cardiovascular disease. There are great details that make this article worth reading, but the long and the short of it points to the need to increase hypertensive control in IGT and diabetes probable patients.
The use of ARB’s as a first line treatment has helped many clinicians get these patients to goal without multiple medications for their hypertension, but in the past 6 months that ability has decreased. Likely one or more of you has had a call from a pharmacist letting you know that valsartan and losartan, the 2 most often prescribed ARB’s, were recalled because of widespread contamination of the active ingredient. It appears there is actually only one supplier for all of these products, and there does not seem to be a solution in sight.
This has caused many prescribers to search for other options. At this time there are a couple of other generic choices, candesartin and olmesartin, and one brand name product, Edarbi (azilsartan).
Based on the Da Qing Diabetes study, you would be wise to move your patients to one of these ARB’s rather than trying a different class.