Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial

Julius, Stevo; Kjeldsen, Sverre E.; Weber, Michael A.; Brunner, Hans R.; Ekman, Steffan; Hansson, Lennart; Hua, Tsushung A.; Laragh, John H.; McInnes, Gordon T.; Mitchell, Lada; Plat, Francis; Schork, Anthony; Smith, Beverly A.; Zanchetti, Alberto

doi:10.1016/s0140-6736(04)16451-9

Cited by 2,262 publications

(849 citation statements)

References 38 publications

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“…The similar benefit of ACE inhibitors or ARBs is less intuitive, but has been demonstrated in the HOPE, LIFE and VALUE trials [32,33,34], amongst others. In the HOPE trial, ramipril reduced the risk of new onset of diabetes by 30% (p = 0.01) in relative terms compared with placebo [32].…”

Section: Prevention Of Diabetes In Patients With the Metabolic Syndromementioning

confidence: 99%

Prevention of Stroke in Patients with Diabetes mellitus and the Metabolic Syndrome

Rothwell

2005

Cerebrovasc Dis

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The basic principles of stroke prevention are the same in patients with diabetes and/or the metabolic syndrome as in those without. Blood-pressure lowering is highly effective in both primary and secondary prevention of stroke in diabetics, and there is no evidence to suggest that the benefits of lipid-lowering therapy are any less. Antiplatelet agents are effective in secondary prevention and may be indicated in asymptomatic diabetic patients, who have a substantially increased risk of acute vascular events. Uncertainty over optimal management of patients with diabetes, and possibly of those with metabolic syndrome, relates more to the thresholds for initiation of treatment. The decision to initiate treatment should depend on the balance between the absolute risk of potentially preventable events and the risks of any complications of treatment. The absolute risks of ischaemic stroke and acute coronary events are significantly increased in diabetics in population-based cohort studies and the recommended thresholds for instigating blood pressure lowering and lipid lowering are therefore lower than in the general population. Optimization of strategies to prevent vascular complications must be a priority, given the rapid rises in the incidence and prevalence of type 2 diabetes and the metabolic syndrome in most populations across the globe.

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Section: Prevention Of Diabetes In Patients With the Metabolic Syndromementioning

confidence: 99%

Prevention of Stroke in Patients with Diabetes mellitus and the Metabolic Syndrome

Rothwell

2005

Cerebrovasc Dis

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“…These drugs decrease not only the risk of macroangiopathy6, 7, 8, but also other diabetic complications9, 10, 11, 12, 13. Furthermore, these drugs also delay the onset of diabetes14, 15, 16.…”

Section: Introductionmentioning

confidence: 99%

Switching from low‐dose thiazide diuretics to sodium–glucose cotransporter 2 inhibitor improves various metabolic parameters without affecting blood pressure in patients with type 2 diabetes and hypertension

Kimura

Sanada

Shimoda

et al. 2017

J of Diabetes Invest

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Aims/IntroductionSodium–glucose cotransporter 2 (SGLT2) inhibitors function to increase urinary glucose excretion and improve glycemic control in individuals with type 2 diabetes mellitus. SGLT2 inhibitors, as well as diuretics, increase urinary volume, which leads to the reduction of blood pressure. The aim of the present study was to compare the effects of SGLT2 inhibitor and thiazide diuretic on blood pressure, metabolic parameters and body mass composition.Materials and MethodsA total of 31 participants were enrolled in the present study. We switched from thiazide diuretics to an SGLT2 inhibitor, ipragliflozin, in participants with type 2 diabetes and hypertension whose blood pressure was controlled with thiazide diuretics. Three months after the switch, we evaluated the effects of such switching on blood pressure, various metabolic parameters and body mass composition.ResultsThere was no significant difference in blood pressure from baseline to 3 months later. However, glycated hemoglobin, fasting plasma glucose and uric acid were significantly decreased after the switch. Body mass index and visceral fat area were also significantly reduced after the switch. Furthermore, urinary albumin excretion was also significantly decreased after the switch.ConclusionsSwitching from thiazide diuretic to an SGLT2 inhibitor, ipragliflozin, markedly improved various metabolic parameters and body mass composition without affecting blood pressure in participants with type 2 diabetes and hypertension.

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“…Several large intervention trials have demonstrated that angiotensin II type 1 receptor antagonists (ARBs) reduce the incidence of new-onset diabetes by 20-25% (1,2). The protective effects of ARBs during the development of diabetes are probably independent of their antihypertensive properties (3,4).…”

Section: Introductionmentioning

confidence: 99%

Effect of telmisartan on selected adipokines, insulin sensitivity, and substrate utilization during insulin-stimulated conditions in patients with metabolic syndrome and impaired fasting glucose

Wohl

Krusinova

Hill

et al. 2010

European Journal of Endocrinology

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Objective: Telmisartan improves glucose and lipid metabolism in rodents. This study evaluated the effect of telmisartan on insulin sensitivity, substrate utilization, selected plasma adipokines and their expressions in subcutaneous adipose tissue (SAT) in metabolic syndrome. Design and methods: Twelve patients with impaired fasting glucose completed the double-blind, randomized, crossover trial. Patients received telmisartan (160 mg/day) or placebo for 3 weeks and vice versa with a 2-week washout period. At the end of each period, a hyperinsulinemic euglycemic clamp (HEC) combined with indirect calorimetry was performed. During HEC (0, 30, and 120 min), plasma levels of adipokines were measured and a needle biopsy (0 and 30 min) of SAT was performed. Results: Fasting plasma glucose was lower after telmisartan compared with placebo (P!0.05). There were no differences in insulin sensitivity and substrate utilization. We found no differences in basal plasma adiponectin, resistin and tumour necrosis factor a (TNFa), but an increase was found in basal leptin, after telmisartan treatment. Insulin-stimulated plasma adiponectin (P!0.05), leptin and resistin (P!0.001) were increased, whereas TNFa was decreased (P!0.05) after telmisartan treatment. Expression of resistin, but not adiponectin, TNFa and leptin was increased after telmisartan treatment. Conclusions: Despite the decrease in fasting plasma glucose, telmisartan does not improve insulin sensitivity and substrate utilization. Telmisartan increases plasma leptin as well as insulin-stimulated plasma adiponectin, leptin and resistin, and decreases plasma TNFa during HEC. Changes in plasma adipokines cannot be explained by their expressions in SAT. The changes in plasma adipokines might be involved in the metabolic effects of telmisartan in metabolic syndrome.

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Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial

Cited by 2,262 publications

References 38 publications

Prevention of Stroke in Patients with Diabetes mellitus and the Metabolic Syndrome

Prevention of Stroke in Patients with Diabetes mellitus and the Metabolic Syndrome

Switching from low‐dose thiazide diuretics to sodium–glucose cotransporter 2 inhibitor improves various metabolic parameters without affecting blood pressure in patients with type 2 diabetes and hypertension

Effect of telmisartan on selected adipokines, insulin sensitivity, and substrate utilization during insulin-stimulated conditions in patients with metabolic syndrome and impaired fasting glucose

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