title: [NAVIGATOR: A trial of prevention of cardiovascular complications and type 2 diabetes with valsartan and/or nateglinide].
abstract: NAVIGATOR ("Nateglinide And Valsartan in Impaired Glucose Tolerance Outcomes Research") is a large international placebo-controlled trial that randomised 9,031 individuals at high risk because of impaired glucose tolerance and established cardiovascular disease or cardiovascular risk factors. This trial aimed at investigating whether valsartan (a selective AT1 receptor antagonist) and/or nateglinide (a short-acting insulin-secreting agent) are able to reduce the incidence of type 2 diabetes and cardiovascular events. After a median follow up of 6.5 years, neither valsartan nor nateglinide improved cardiovascular prognosis in the tested population, which already benefited from a protective pharmacotherapy at baseline and a reinforcement of lifestyle modification throughout the trial. Nateglinide did not diminish the risk of new onset diabetes. In contrast, valsartan reduced the incidence of type 2 diabetes by 14%, confirming the potential interest of the blockade of the renin-angiotensin system in this high-risk population.
authors.affiliation: Université de Liège, Belgique.
authors.forename: A J
authors.initials: AJ
authors.lastname: Scheen
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D001530:Belgium; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003510:Cyclohexanes / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D000077715:Nateglinide; D010649:Phenylalanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012084:Renin-Angiotensin System / Q000187:drug effects; D013777:Tetrazoles / Q000627:therapeutic use*; D016896:Treatment Outcome; D014633:Valine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000068756:Valsartan
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D003510:Cyclohexanes; D007004:Hypoglycemic Agents; D013777:Tetrazoles; D000077715:Nateglinide; D010649:Phenylalanine; D000068756:Valsartan; D014633:Valine