Comparison between valsartan and amlodipine regarding cardiovascular morbidity and mortality in hypertensive patients with glucose intolerance: NAGOYA HEART study

Takashi Muramatsu, Kunihiro Matsushita, Kentaro Yamashita, Takahisa Kondo, Kengo Maeda, Satoshi Shintani, Satoshi Ichimiya, Miyoshi Ohno, Takahito Sone, Nobuo Ikeda, Masato Watarai, Toyoaki Murohara

Research output: Contribution to journalArticle

Abstract

It has not been fully examined whether angiotensin II receptor blocker is superior to calcium channel blocker to reduce cardiovascular events in hypertensive patients with glucose intolerance. A prospective, open-labeled, randomized, controlled trial was conducted for Japanese hypertensive patients with type 2 diabetes mellitus or impaired glucose tolerance. A total of 1150 patients (women: 34%; mean age: 63 years; diabetes mellitus: 82%) were randomly assigned to receive either valsartan- or amlodipine-based antihypertensive treatment. Primary outcome was a composite of acute myocardial infarction, stroke, coronary revascularization, admission attributed to heart failure, or sudden cardiac death. Blood pressure was 145/82 and 144/81 mm Hg, and glycosylated hemoglobin was 7.0% and 6.9% at baseline in the valsartan group and the amlodipine group, respectively. Both of them were equally controlled between the 2 groups during the study. The median follow-up period was 3.2 years, and primary outcome had occurred in 54 patients in the valsartan group and 56 in the amlodipine group (hazard ratio: 0.97 [95% CI: 0.66-1.40]; P=0.85). Patients in the valsartan group had a significantly lower incidence of heart failure than in the amlodipine group (hazard ratio: 0.20 [95% CI: 0.06-0.69]; P=0.01). Other components and all-cause mortality were not significantly different between the 2 groups. Composite cardiovascular outcomes were comparable between the valsartan- and amlodipine-based treatments in Japanese hypertensive patients with glucose intolerance. Admission because of heart failure was significantly less in the valsartan group.

Original languageEnglish (US)
Pages (from-to)580-586
Number of pages7
JournalHypertension
Volume59
Issue number3
DOIs
StatePublished - Mar 2012
Externally publishedYes

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Keywords

  • angiotensin II type 1 receptor blocker
  • calcium channel blocker
  • cardiovascular disease
  • diabetes mellitus
  • hypertension
  • impaired glucose tolerance

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Muramatsu, T., Matsushita, K., Yamashita, K., Kondo, T., Maeda, K., Shintani, S., Ichimiya, S., Ohno, M., Sone, T., Ikeda, N., Watarai, M., & Murohara, T. (2012). Comparison between valsartan and amlodipine regarding cardiovascular morbidity and mortality in hypertensive patients with glucose intolerance: NAGOYA HEART study. Hypertension, 59(3), 580-586. https://doi.org/10.1161/HYPERTENSIONAHA.111.184226