Effects of valsartan compared to amlodipine on preventing type 2 diabetes in high-risk hypertensive patients: The VALUE trial

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 - 2006/6/1

Y1 - 2006/6/1

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 - https://www.scopus.com/pages/publications/33745464829

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 -