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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Risk of new-onset diabetes in the Losartan Intervention For Endpoint reduction in hypertension study
Journal of Hypertension, Volume 20, No. 9, Year 2002
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Description
Background: There has been uncertainty about the risk of new-onset diabetes in hypertensive individuals treated with different blood pressure-decreasing drugs. Objectives: To study this risk in hypertensive individuals who were at risk of developing diabetes mellitus in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. Methods: In the LIFE study, with a double-masked, randomized, parallel-group design, 9193 patients (46% men) with hypertension (mean age 67 years, average pressure 174/98 mmHg after placebo run-in) and electrocardiogram-documented left ventricular hypertrophy were randomly assigned to once-daily losartan- or atenolol-based antihypertensive treatment and followed for at least 4 years (mean 4.8 years). At baseline, 7998 patients did not have diabetes mellitus and were thus at risk of developing this condition during the study. To demonstrate ability to predict new-onset diabetes, we developed a prediction score using the significant variables from multivariate analyses (serum glucose, body mass index, serum high-density lipoprotein cholesterol, systolic blood pressure and history of prior use of antihypertensive drugs). Results: There was a steadily increasing risk of diabetes with increasing level-of-risk score; patients in the highest quartile were at considerably greater risk than those in the three lower ones. Treatment with losartan was associated with lower risk of development of diabetes within each of the four quartiles of the risk score. As previously reported, new-onset diabetes mellitus occurred in 242 patients receiving losartan (13.0 per 1000 person-years) and 320 receiving atenolol (17.5 per 1000 person-years); relative risk 0.75 (95% confidence interval 0.63 to 0.88; P < 0.001). Conclusions: New-onset diabetes could be strongly predicted by a newly developed risk score using baseline serum glucose concentration (non-fasting), body mass index, serum high-density lipoprotein cholesterol concentration, systolic blood pressure and history of prior use of antihypertensive drugs. Independently of these risk factors, fewer hypertensive patients with left ventricular hypertrophy developed diabetes mellitus if they were treated with losartan than if they were treated with atenolol. © 2002 Lippincott Williams & Wilkins.
Authors & Co-Authors
Lindholm, Lars Hjalmar J.
Sweden, Umea
Norrlands Universitetssjukhus
Ibsen, Hans Henning Windeløv
Sweden, Umea
Norrlands Universitetssjukhus
Borch-Johnsen, Knut
Sweden, Umea
Norrlands Universitetssjukhus
Olsen, Michael Hecht
Sweden, Umea
Norrlands Universitetssjukhus
Wachtell, Kristian
Sweden, Umea
Norrlands Universitetssjukhus
Dahlof̈, Björn L.
Sweden, Umea
Norrlands Universitetssjukhus
Devereux, Richard Blyton
Sweden, Umea
Norrlands Universitetssjukhus
Dé Fairé, Ulf H.
Sweden, Umea
Norrlands Universitetssjukhus
Julius, Stevo
Sweden, Umea
Norrlands Universitetssjukhus
Kjeldsen, Sverre Erik
Sweden, Umea
Norrlands Universitetssjukhus
Nieminen, Markku Sakari
Sweden, Umea
Norrlands Universitetssjukhus
Oparil, Suzanne
Sweden, Umea
Norrlands Universitetssjukhus
Wedel, Hans
Sweden, Umea
Norrlands Universitetssjukhus
Statistics
Citations: 371
Authors: 13
Affiliations: 1
Identifiers
Doi:
10.1097/00004872-200209000-00035
ISSN:
02636352
Research Areas
Noncommunicable Diseases
Study Design
Randomised Control Trial
Participants Gender
Male