Effect of valsartan on the incidence of diabetes and cardiovascular events

  • Califf R
  • McMurray J
  • Holman R
 et al. 
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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

Author-supplied keywords

  • Alicyclic -- Therapeutic Use
  • Angiotensin II Type 1 Receptor Blockers [adverse e
  • Angiotensin II Type I Receptor Blockers -- Adverse
  • Angiotensin II Type I Receptor Blockers -- Therape
  • Blood Glucose -- Analysis
  • Blood Glucose -- Drug Effects
  • Blood Pressure -- Drug Effects
  • Body Weight -- Drug Effects
  • Cardiovascular Diseases -- Epidemiology
  • Cardiovascular Diseases -- Mortality
  • Cardiovascular Diseases -- Prevention and Control
  • Combination
  • Combination Exercise Follow-Up Studies Glucose Int
  • Cox Proportional Hazards Model
  • Diabetes Mellitus
  • Double-Blind Studies
  • Drug Therapy
  • Exercise
  • Female
  • Glucose Intolerance -- Diet Therapy
  • Glucose Intolerance -- Drug Therapy
  • Glucose Intolerance -- Therapy
  • Heterocyclic Compounds -- Adverse Effects
  • Heterocyclic Compounds -- Therapeutic Use
  • Human
  • Hydrocarbons
  • Hypoglycemic Agents -- Therapeutic Use
  • Incidence
  • Male
  • Middle Age
  • Phenylalanine
  • Phenylalanine -- Therapeutic Use
  • Prospective Studies
  • Risk Factors
  • Type 2 -- Epidemiology
  • Type 2 -- Prevention and Control
  • Type 2 [epidemiology] [prevention & control] Doubl
  • Valine
  • Valine -- Adverse Effects
  • Valine -- Therapeutic Use
  • adult arthralgia/si [Side Effect] article backache

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  • Rm Califf

  • Jj McMurray

  • Rr Holman

  • Sm Haffner

  • Ma Bethel

  • B Holzhauer

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