no knowledge regarding the cost effectiveness of anti-hypertensive drugs on the subject of the development of diabetes are available. Not only from a medical or economical but in addition from an ethical viewpoint, it’s debateable if it is reasonable to treat people E3 ligase inhibitor with diuretics and/or beta blockers if they have risk factors besides hypertension for developing diabetes mellitus. The anti-hypertensive therapy goals are avoiding cardiovascular mortality and cardiovascular events. The therapeutic benefit of the anti-hypertensive treatment has to be weighed against the risk of developing diabetes mellitus. Diabetes it self can be associated with a higher risk for cardio-vascular events and leads to death if left untreated. It remains to treat people at risk for cardiovascular events with drugs, which promote conditions which could again increase this risk. Could it be justifiable to treat hypertension and recognize the development of diabetesfi Based on the guidelines Urogenital pelvic malignancy of the German Hypertension League and the German Society of Hypertension, diuretics and beta-blockers shouldn’t be prescribed for patients with metabolic syndrome or rather with different specific manifestations of the metabolic syndrome. Regarding appropriate features, non compliance of the guidelines could be viewed as a treatment error. A treatment error only does occur when the error leads to impairment and the patient is able to prove the causality. This could be difficult, unless the patient was not informed adequately about the possible danger of developing diabetes mellitus within the course of treatment with diuretics and/or beta blockers. Conclusions/recommendations Anti-hypertensive treatment includes a significant impact on the incidence of diabetes mellitus, whereas the incidence is higher for patients treated with diuretics or betablockers than for patients treated Dasatinib 302962-49-8 with calcium channelblockers, ACE inhibitors and ARB. This result is significantly stronger when both substance classes are employed in combination. The outcomes of the publications within this report present a medically relevant limitation for the usage of diuretics and beta-blockers. Patients with insulin resistant states, hypertension, disadvantaged plasmaglucose, obesity and heart failure should ideally be treated with ACE inhibitors and ARB. Further research is required to confirm the role of ACE inhibitors and ARB in the prevention of type 2 diabetes and to assess the risk for cardio-vascular events and mortality because of drug induced diabetes. From the health economic point of view, evidence is lacking regarding the cost effectiveness of the newer antihypertensive drugs in Germany. Predicated on costs for diabetes mellitus and its complications, the idea is made that the usage of antihypertensive drugs, which result in a lower diabetes incidence, may also be considered economical for the German health care system.