Anti-hypertensive drug use and the risk of serious hypoglycemia in patients with diabetes

Recently, there have been conflicting reports on whether anti-hypertensive medications cause serious hypoglycemia in patients with diabetes. We assessed this association using a population-based approach.Utilizing the Saskatchewan Health databases, we conducted a case-control study nested within a cohort of 3639 patients with diabetes, newly prescribed angiotensin converting enzyme inhibitors (ACE-I) or dispensed other anti-hypertensive drugs during 1982 to 1987. There were 162 cases of hypoglycemia identified. All potential controls, matched to the case on entry date and at different eligible at-risk times, were selected (n = 8329).After adjustment for confounders, current users of ACE-I and non-selective beta-blockers had a clinically important increased risk of hypoglycemia, RR 1.61 (95% CI: 0.99--2.60) and RR 1.81 (0.97--3.40), respectively. Current users of ACE-I for a duration of 120 days or greater had a 2-fold increased hypoglycemic risk, RR 2.06 (1.12--3.82).The use of ACE-I and non-selective beta-blockers may be associated with serious hypoglycemia