title: Predictors of cardiac morbidity in diabetic, new-onset diabetic and non-diabetic high-risk hypertensive patients: The Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial.
abstract: Diabetic and new-onset diabetic patients with hypertension have higher cardiac morbidity than patients without diabetes. We aimed to investigate whether baseline predictors of cardiac morbidity, the major constituent of the primary endpoint in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial, were different in patients with diabetes and new-onset diabetes compared to patients without diabetes. In total, 15,245 high-risk hypertensive patients in the VALUE trial were followed for an average of 4.2 years. At baseline, 5250 patients were diabetic by the 1999 World Health Organization criteria, 1298 patients developed new-onset diabetes and 8697 patients stayed non-diabetic during follow-up. Cardiac morbidity was defined as a composite of myocardial infarction and heart failure requiring hospitalization, and baseline predictors were identified by univariate and multivariate stepwise Cox regression analyses. History of coronary heart disease (CHD) and age were the most important predictors of cardiac morbidity in both diabetic and non-diabetic patients. History of CHD, history of stroke and age were the only significant predictors of cardiac morbidity in patients with new-onset diabetes. Predictors of cardiac morbidity, in particular history of CHD and age, were essentially the same in high-risk hypertensive patients with diabetes, new-onset diabetes and without diabetes who participated in the VALUE trial.
authors.affiliation: a Department of Cardiology , Oslo University Hospital , Ullevål , Oslo , Norway ;
authors.forename: Tonje A
authors.initials: TA
authors.lastname: Aksnes
authors.affiliation: a Department of Cardiology , Oslo University Hospital , Ullevål , Oslo , Norway ;
authors.forename: Sverre E
authors.initials: SE
authors.lastname: Kjeldsen
authors.affiliation: b Department of Acute Medicine , Oslo University Hospital , Ullevål , Oslo , Norway ;
authors.forename: Morten
authors.initials: M
authors.lastname: Rostrup
authors.affiliation: c Novartis Pharma , Basel , Switzerland ;
authors.forename: Björn
authors.initials: B
authors.lastname: Holzhauer
authors.affiliation: d Novartis Pharma , East Hanover , NJ , USA ;
authors.forename: Tsushung A
authors.initials: TA
authors.lastname: Hua
authors.affiliation: e Division of Cardiovascular Medicine , University of Michigan , Ann Arbor , MI , USA.
authors.forename: Stevo
authors.initials: S
authors.lastname: Julius
mesh_terms: D017311:Amlodipine / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D048909:Diabetes Complications / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006333:Heart Failure / Q000209:etiology* / Q000503:physiopathology; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D000068756:Valsartan / Q000627:therapeutic use*
chemical_list: D000959:Antihypertensive Agents; D017311:Amlodipine; D000068756:Valsartan
keywords: Blood pressure; cardiovascular risk; coronary heart disease; diabetes mellitus; heart failure; hypertension; myocardial infarction