Antihypertensive Medications and the Risk of Incident Type 2 Diabetes: Response to Gosmanov et al. Free

We thank Gosmanov et al. (1) for their comments. As stated in our article (2) and the accompanying editorial (3), data on the specific use of ACE inhibitors were obtained only in the Nurses’ Health Study (NHS) I and data for specific antihypertensive medication use in NHS II were limited to thiazide diuretic use. Thus, NHS II participants reporting the use of “other” antihypertensive medications may have been taking β-blockers, calcium channel blockers, or ACE inhibitors, and Health Professional Follow-up Study participants reporting the use of “other” antihypertensive medications may have been taking ACE inhibitors. For each cohort, we can only speculate on the meaning of the “other” category risk estimates, which were generated by multivariate analyses that adjusted for the use of each class of antihypertensive drug. Of note, we performed subanalyses in each cohort restricted to participants treated with only one class of antihypertensive medication. These analyses excluded participants reporting the use of “other” antihypertensive agents. The positive relation between monotherapy and risk supports the conclusions of our primary analyses that thiazide diuretics (in all three cohorts) and β-blockers (in NHS I and the Health Professional Follow-up Study) were independently associated with the development of incident diabetes.