TY - JOUR
T1 - Effects of valsartan compared to amlodipine on preventing type 2 diabetes in high-risk hypertensive patients
T2 - The VALUE trial
AU - Kjeldsen, Sverre E.
AU - Julius, Stevo
AU - Mancia, Giuseppe
AU - McInnes, Gordon T.
AU - Hua, Tsushung
AU - Weber, Michael A.
AU - Coca, Antonio
AU - Ekman, Steffan
AU - Girerd, Xavier
AU - Jamerson, Kenneth
AU - Larochelle, Pierre
AU - MacDonald, Thomas M.
AU - Schmieder, Roland E.
AU - Schork, M. Anthony
AU - Stolt, Pelle
AU - Viskoper, Reuven
AU - Widimský, Jiri
AU - Zanchetti, Alberto
PY - 2006/1/1
Y1 - 2006/1/1
N2 - CONTEXT: Type 2 diabetes is emerging as a major health problem, which tends to cluster with hypertension in individuals at high risk of cardiovascular disease. OBJECTIVE: To test for the first time the hypothesis that treatment of hypertensive patients at high cardiovascular risk with the angiotensin-receptor blocker (ARB) valsartan prevents new-onset type 2 diabetes compared with the metabolically neutral calcium-channel antagonist (CCA) amlodipine. DESIGN: Pre-specified analysis in the VALUE trial. Follow-up averaged 4.2 years. The risk of developing new diabetes was calculated as an odds ratio (OR) with 95% confidence intervals (CI) for different definitions of diabetes. PATIENTS: A sample of 9995 high-risk, non-diabetic hypertensive patients. INTERVENTIONS: Valsartan or amlodipine with or without add-on medication [hydrochlorothiazide (HCTZ) and other add-ons, excluding other ARBs, angiotensin-converting enzyme (ACE) inhibitors, CCAs]. MAIN OUTCOME MEASURE: New diabetes defined as an adverse event, new blood-glucose-lowering drugs and/or fasting glucose > 7.0 mmol/l. RESULTS: New diabetes was reported in 580 (11.5%) patients on valsartan and in 718 (14.5%) patients on amlodipine (OR 0.77, 95% CI 0.69-0.87, P < 0.0001). Using stricter criteria (without adverse event reports) new diabetes was detected in 495 (9.8%) patients on valsartan and in 586 (11.8%) on amlodipine (OR 0.82, 95% CI 0.72-0.93, P = 0.0015). CONCLUSION: Compared with amlodipine, valsartan reduces the risk of developing diabetes mellitus in high-risk hypertensive patients.
AB - CONTEXT: Type 2 diabetes is emerging as a major health problem, which tends to cluster with hypertension in individuals at high risk of cardiovascular disease. OBJECTIVE: To test for the first time the hypothesis that treatment of hypertensive patients at high cardiovascular risk with the angiotensin-receptor blocker (ARB) valsartan prevents new-onset type 2 diabetes compared with the metabolically neutral calcium-channel antagonist (CCA) amlodipine. DESIGN: Pre-specified analysis in the VALUE trial. Follow-up averaged 4.2 years. The risk of developing new diabetes was calculated as an odds ratio (OR) with 95% confidence intervals (CI) for different definitions of diabetes. PATIENTS: A sample of 9995 high-risk, non-diabetic hypertensive patients. INTERVENTIONS: Valsartan or amlodipine with or without add-on medication [hydrochlorothiazide (HCTZ) and other add-ons, excluding other ARBs, angiotensin-converting enzyme (ACE) inhibitors, CCAs]. MAIN OUTCOME MEASURE: New diabetes defined as an adverse event, new blood-glucose-lowering drugs and/or fasting glucose > 7.0 mmol/l. RESULTS: New diabetes was reported in 580 (11.5%) patients on valsartan and in 718 (14.5%) patients on amlodipine (OR 0.77, 95% CI 0.69-0.87, P < 0.0001). Using stricter criteria (without adverse event reports) new diabetes was detected in 495 (9.8%) patients on valsartan and in 586 (11.8%) on amlodipine (OR 0.82, 95% CI 0.72-0.93, P = 0.0015). CONCLUSION: Compared with amlodipine, valsartan reduces the risk of developing diabetes mellitus in high-risk hypertensive patients.
KW - Amlodipine
KW - Angiotensin receptor blocker
KW - Calcium-channel antagonist
KW - Cardiovascular disease
KW - Clinical trial
KW - Hypertension
KW - New-onset diabetes
KW - Valsartan
UR - http://www.scopus.com/inward/record.url?scp=33745464829&partnerID=8YFLogxK
U2 - 10.1097/01.hjh.0000234122.55895.5b
DO - 10.1097/01.hjh.0000234122.55895.5b
M3 - Article
C2 - 16794491
AN - SCOPUS:33745464829
SN - 0263-6352
VL - 24
SP - 1405
EP - 1412
JO - Journal of Hypertension
JF - Journal of Hypertension
IS - 7
ER -