title: Effects of valsartan compared to amlodipine on preventing type 2 diabetes in high-risk hypertensive patients: the VALUE trial.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  A sample of 9995 high-risk, non-diabetic hypertensive patients.
  
  
  METHODS
  Valsartan or amlodipine with or without add-on medication [hydrochlorothiazide (HCTZ) and other add-ons, excluding other ARBs, angiotensin-converting enzyme (ACE) inhibitors, CCAs].
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  Compared with amlodipine, valsartan reduces the risk of developing diabetes mellitus in high-risk hypertensive patients.
authors.affiliation: Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Sverre E
authors.initials: SE
authors.lastname: Kjeldsen
authors.forename: Stevo
authors.initials: S
authors.lastname: Julius
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
authors.forename: Gordon T
authors.initials: GT
authors.lastname: McInnes
authors.forename: Tsushung
authors.initials: T
authors.lastname: Hua
authors.forename: Michael A
authors.initials: MA
authors.lastname: Weber
authors.forename: Antonio
authors.initials: A
authors.lastname: Coca
authors.forename: Steffan
authors.initials: S
authors.lastname: Ekman
authors.forename: Xavier
authors.initials: X
authors.lastname: Girerd
authors.forename: Kenneth
authors.initials: K
authors.lastname: Jamerson
authors.forename: Pierre
authors.initials: P
authors.lastname: Larochelle
authors.forename: Thomas M
authors.initials: TM
authors.lastname: MacDonald
authors.forename: Roland E
authors.initials: RE
authors.lastname: Schmieder
authors.forename: M Anthony
authors.initials: MA
authors.lastname: Schork
authors.forename: Pelle
authors.initials: P
authors.lastname: Stolt
authors.forename: Reuven
authors.initials: R
authors.lastname: Viskoper
authors.forename: Jiri
authors.initials: J
authors.lastname: Widimský
authors.forename: Alberto
authors.initials: A
authors.lastname: Zanchetti
mesh_terms: D000368:Aged; D017311:Amlodipine / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013777:Tetrazoles / Q000627:therapeutic use*; D014633:Valine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000068756:Valsartan
chemical_list: D000959:Antihypertensive Agents; D013777:Tetrazoles; D017311:Amlodipine; D000068756:Valsartan; D014633:Valine