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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Effect of valsartan on the incidence of diabetes and cardiovascular events
New England Journal of Medicine, Volume 362, No. 16, Year 2010
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Description
Background: It is not known whether drugs that block the renin-angiotensin system reduce the risk of diabetes and cardiovascular events in patients with impaired glucose tolerance. Methods: In this double-blind, randomized clinical trial with a 2-by-2 factorial design, we assigned 9306 patients with impaired glucose tolerance and established cardiovascular disease or cardiovascular risk factors to receive valsartan (up to 160 mg daily) or placebo (and nateglinide or placebo) in addition to lifestyle modification. We then followed the patients for a median of 5.0 years for the development of diabetes (6.5 years for vital status). We studied the effects of valsartan on the occurrence of three coprimary outcomes: the development of diabetes; an extended composite outcome of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, hospitalization for heart failure, arterial revascularization, or hospitalization for unstable angina; and a core composite outcome that excluded unstable angina and revascularization. Results: The cumulative incidence of diabetes was 33.1% in the valsartan group, as compared with 36.8% in the placebo group (hazard ratio in the valsartan group, 0.86; 95% confidence interval [CI], 0.80 to 0.92; P<0.001). Valsartan, as compared with placebo, did not significantly reduce the incidence of either the extended cardiovascular outcome (14.5% vs. 14.8%; hazard ratio, 0.96; 95% CI, 0.86 to 1.07; P = 0.43) or the core cardiovascular outcome (8.1% vs. 8.1%; hazard ratio, 0.99; 95% CI, 0.86 to 1.14; P = 0.85). Conclusions: Among patients with impaired glucose tolerance and cardiovascular disease or risk factors, the use of valsartan for 5 years, along with lifestyle modification, led to a relative reduction of 14% in the incidence of diabetes but did not reduce the rate of cardiovascular events. (ClinicalTrials.gov number, NCT00097786.). Copyright © 2010 Massachusetts Medical Society. All rights reserved.
Authors & Co-Authors
Califf, Robert M.
Unknown Affiliation
McMurray, John JV
Unknown Affiliation
Holman, Rury R.
Unknown Affiliation
Haffner, Steven M.
Unknown Affiliation
Bethel, M. Angelyn
Unknown Affiliation
Holzhauer, Björn
Unknown Affiliation
Hua, Tsushung A.
Unknown Affiliation
Belenkov, Yu N.
Unknown Affiliation
Boolell, Mitradev
Unknown Affiliation
Buse, John B.
Unknown Affiliation
Buckley, Brendan M.
Unknown Affiliation
Chacra, Antǒnio Roberto
Unknown Affiliation
Chiang, Fu Tien
Unknown Affiliation
Charbonnel, Bernard H.
Unknown Affiliation
Chow, Chun Chung
Unknown Affiliation
Davies, Melanie J.
Unknown Affiliation
Deedwania, Prakash Ć.
Unknown Affiliation
Diem, Peter
Unknown Affiliation
Einhorn, Daniel
Unknown Affiliation
Fonseca, Vivian A.
Unknown Affiliation
Fulcher, Greg R.
Unknown Affiliation
Gaciong, Zbigniew A.
Unknown Affiliation
Gaztambide, Sonia
Unknown Affiliation
Giles, Thomas D.
Unknown Affiliation
Horton, Edward S.
Unknown Affiliation
İlkova, Hasan M.
Unknown Affiliation
Jenssen, Trond
Unknown Affiliation
Kahn, Steven E.
Unknown Affiliation
Krum, Henry
Unknown Affiliation
Laakso, M. M.
Unknown Affiliation
Leiter, Lawrence Alan
Unknown Affiliation
Levitt, Naomi S.
Unknown Affiliation
Mareev, Vyacheslav
Unknown Affiliation
Martínez, Felipe A.
Unknown Affiliation
Masson, Chantal
Unknown Affiliation
Mazzone, Theodore
Unknown Affiliation
Meaney, Eduardo
Unknown Affiliation
Nesto, Richard W.
Unknown Affiliation
Pan, Changyu
Unknown Affiliation
Präger, Rudolf J.F.
Unknown Affiliation
Raptis, Sotirios A.
Unknown Affiliation
Rutten, Guy E.H.M.
Unknown Affiliation
Sandstroem, Herbert
Unknown Affiliation
Schaper, Frank
Unknown Affiliation
Scheen, André J.
Unknown Affiliation
Schmitz, Ole E.
Unknown Affiliation
Sinay, Isaac Rubén
Unknown Affiliation
Soška, Vladimír
Unknown Affiliation
Stender, Steen
Unknown Affiliation
Tamás, Gyula
Unknown Affiliation
Tognoni, Gianni
Unknown Affiliation
Tuomilehto, Jaakko O.I.
Unknown Affiliation
Villamil, Alberto S.
Unknown Affiliation
Vozár, Juraj
Unknown Affiliation
Statistics
Citations: 54
Authors: 54
Affiliations: 53
Identifiers
Doi:
10.1056/NEJMoa1001121
ISSN:
00284793
e-ISSN:
15334406
Research Areas
Disability
Environmental
Noncommunicable Diseases
Study Design
Randomised Control Trial
Cohort Study