Relation between cardiovascular complications and blood pressure/blood glucose control in diabetic patients with hypertension receiving long-term candesartan cilexetil therapy: Challenge-DM study.
OBJECTIVE
To investigate the relation between cardiovascular events and blood pressure or blood glucose control during long-term treatment with candesartan cilexetil in Japanese patients with hypertension and diabetes mellitus.


METHODS
During a planned 3-year follow-up period, five surveys were performed (at registration, after 6 months, and after 1-3 years).


RESULTS
Among 17,622 patients registered nationwide, 16,869 were available for safety evaluation and 16,860 for efficacy evaluation. The actual mean follow-up period was 29 months, and the annual incidence of primary cardiovascular events was 17.4/1000 persons. After 3 years, 18.0% of the patients had a blood pressure <130/80 mmHg, while 45.4% had a hemoglobin A(1c) <6.5%. Compared with these patients showing good control of hypertension and/or diabetes, the incidence of cardiovascular events was significantly higher in patients with poor control.


CONCLUSIONS
These findings emphasize the importance of tight blood pressure and glycemic control in hypertensive patients with diabetes. In addition, the target blood pressure (<130/80 mmHg) in the 2004 Japanese Hypertension Management Guidelines and the target hemoglobin A(1c) (<6.5%) in the Japanese Treatment Guide for Diabetes were supported.
Kawamori
Ryuzo
R
Department of Medicine, Juntendo University School of Medicine, Tokyo, Japan. kawamori@juntendo.ac.jp
Fujita
Toshiro
T
Matsuoka
Hiroaki
H
Umemura
Satoshi
S
Saito
Yasushi
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001562:Benzimidazoles / Q000627:therapeutic use*; D001713:Biphenyl Compounds / Q000627:therapeutic use*; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects*; D002318:Cardiovascular Diseases / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011358:Product Surveillance, Postmarketing; D013777:Tetrazoles / Q000627:therapeutic use*; D013997:Time Factors; D055815:Young Adult
D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D001786:Blood Glucose; D013777:Tetrazoles; C077793:candesartan cilexetil