TY - JOUR
T1 - Effects of valsartan versus amlodipine in diabetic hypertensive patients with or without previous cardiovascular disease
AU - Yamashita, Kentaro
AU - Kondo, Takahisa
AU - Muramatsu, Takashi
AU - Matsushita, Kunihiro
AU - Nagahiro, Takanori
AU - Maeda, Kengo
AU - Shintani, Satoshi
AU - Murohara, Toyoaki
N1 - Funding Information:
The NAGOYA HEART Study was funded and supported by Nagoya University Graduate School of Medicine (Nagoya, Japan). The Department of Cardiology, Nagoya University Graduate School of Medicine reported receiving research promotion grants (Shougaku Kifukin) from Actelion (Tokyo, Japan), Astellas (Tokyo, Japan), Bayer (Osaka, Japan), Boehringer Ingelheim (Tokyo, Japan), Chugai (Tokyo, Japan), Daiichi Sankyo (Tokyo, Japan), Dainippon Sumitomo (Osaka, Japan), Eisai (Tokyo, Japan), Fujifilm RI (Tokyo, Japan), Kaken (Tokyo, Japan), Kowa (Nagoya, Japan), Kureha (Tokyo, Japan), Medtronic (Tokyo, Japan), Mitsubishi Tanabe (Osaka, Japan), Mochida (Tokyo, Japan), MSD (Tokyo, Japan), Novartis (Tokyo, Japan), Pfizer (Tokyo, Japan), Sanofi-Aventis (Tokyo, Japan), Schering-Plough (Osaka, Japan), and Takeda (Osaka, Japan). However, the research topics of these donation grants are not restricted.
PY - 2013/12/1
Y1 - 2013/12/1
N2 - Recently, we reported that angiotensin II receptor blocker (ARB), valsartan, and calcium channel blocker (CCB), amlodipine, had similar effects on the prevention of cardiovascular disease (CVD) events in diabetic hypertensive patients. We assessed the difference of cardiovascular protective effects between ARB and CCB in patients with and without previous CVD, respectively. A total of 1,150 Japanese diabetic hypertensive patients were randomized to either valsartan or amlodipine treatment arms, which were additionally divided into 2 groups according to the presence of previous CVD at baseline (without CVD, n = 818; with CVD, n = 332). The primary composite outcomes were sudden cardiac death, acute myocardial infarction, stroke, coronary revascularization, or hospitalization for heart failure. The incidence of primary end point events in patients with previous CVD was 3.5-times greater than that in patients without previous CVD (64.1 vs 17.9/1,000 person-years). The ARB- and the CCB-based treatment arms showed similar incidence of composite CVD events in both patients without previous CVD (hazard ratio [HR] 1.35, 95% confidence interval [CI] 0.76 to 2.40) and those with previous CVD (HR 0.79, 95% CI 0.48 to 1.31). The ARB-treatment arm showed less incidence of stroke compared with the CCB-based treatment arm in patients with previous CVD (HR 0.24, 95% CI 0.05 to 1.11, p = 0.068), whereas the 2 treatment arms showed similar incidence of stroke in patients without previous CVD (HR 1.52, 95% CI 0.59 to 3.91). In conclusion, the ARB- and the CCB-based treatments exerted similar protective effects of CVD events regardless of the presence of previous CVD. For stroke events, the ARB may have more protective effects than the CCB in diabetic hypertensive patients with previous CVD.
AB - Recently, we reported that angiotensin II receptor blocker (ARB), valsartan, and calcium channel blocker (CCB), amlodipine, had similar effects on the prevention of cardiovascular disease (CVD) events in diabetic hypertensive patients. We assessed the difference of cardiovascular protective effects between ARB and CCB in patients with and without previous CVD, respectively. A total of 1,150 Japanese diabetic hypertensive patients were randomized to either valsartan or amlodipine treatment arms, which were additionally divided into 2 groups according to the presence of previous CVD at baseline (without CVD, n = 818; with CVD, n = 332). The primary composite outcomes were sudden cardiac death, acute myocardial infarction, stroke, coronary revascularization, or hospitalization for heart failure. The incidence of primary end point events in patients with previous CVD was 3.5-times greater than that in patients without previous CVD (64.1 vs 17.9/1,000 person-years). The ARB- and the CCB-based treatment arms showed similar incidence of composite CVD events in both patients without previous CVD (hazard ratio [HR] 1.35, 95% confidence interval [CI] 0.76 to 2.40) and those with previous CVD (HR 0.79, 95% CI 0.48 to 1.31). The ARB-treatment arm showed less incidence of stroke compared with the CCB-based treatment arm in patients with previous CVD (HR 0.24, 95% CI 0.05 to 1.11, p = 0.068), whereas the 2 treatment arms showed similar incidence of stroke in patients without previous CVD (HR 1.52, 95% CI 0.59 to 3.91). In conclusion, the ARB- and the CCB-based treatments exerted similar protective effects of CVD events regardless of the presence of previous CVD. For stroke events, the ARB may have more protective effects than the CCB in diabetic hypertensive patients with previous CVD.
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U2 - 10.1016/j.amjcard.2013.07.043
DO - 10.1016/j.amjcard.2013.07.043
M3 - Article
C2 - 24035165
AN - SCOPUS:84888001221
SN - 0002-9149
VL - 112
SP - 1750
EP - 1756
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 11
ER -
