[Syst-Eur study: analysis of the benefits of nitrendipine in hypertensive type 2 diabetics].
OBJECTIVE
To demonstrate that nitrendipine reduces the morbimortality of elderly type 2 diabetic patients with isolated systolic hypertension.


METHODS
New analyses of the 547 type 2 diabetics patients with isolated systolic hypertension (160 < PAS < 219: PAD < 95 mmHg), included in the international Syst-Eur trial, with an average follow-up of 2 years. Type 2 diabetes is defined according to the 1998 WHO guidelines: a fasting glycemia level, > or = 126 mg/dl and a post-prandial glycemia > or = 200 mg/dl.


RESULTS
Nitrendipine as a first line treatment provides better protection against fatal and no fatal cardiovascular events compared with placebo. The risk reduction of cardiovascular mortality is 70% (IC 95%: -89/-18; p = 0.01), 61% (IC 95%: -79/-29; p = 0.001) for fatal and non fatal cardiovascular events, 65% (IC 95%: -86/-10; p = 0.02) for fatal and non fatal stroke and 61% (IC 95%: -83/-11; p = 0.02) for fatal and non fatal cardiac events. Therefore, nitrendipine as a first line treatment, reduces significantly cardiovascular events, strokes and cardiac events (p = 0.02; p = 0.007; p = 0.009; p = 0.04, respectively) in the diabetic group versus the no diabetic group, with a big trend (p = 0.07) for total mortality. Nitrendipine was well tolerated by this population.


CONCLUSIONS
These results demonstrate the benefits of nitrendipine as a first line treatment in type 2 diabetic hypertensive patients.
Safar
M
M
Hôpital Broussais, 96, rue Didot, 75674 Paris.
Thijs
L
L
Staessen
J A
JA
D000959:Antihypertensive Agents / Q000494:pharmacology*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000209:etiology; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D009568:Nitrendipine / Q000494:pharmacology*; D012307:Risk Factors; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents; D007328:Insulin; D009568:Nitrendipine