Differing effects of antihypertensive drugs on the incidence of diabetes mellitus among patients with hypertensive kidney disease

Denyse Thornley-Brown, Xuelei Wang, Jackson T. Wright, Otelio S. Randall, Edgar R Miller, James P. Lash, Jennifer Gassman, Gabriel Contreras, Lawrence Appel, Lawrence Y. Agodoa, DeAnna Cheek

Research output: Contribution to journalArticle

Abstract

Background: The African American Study of Kidney Disease and Hypertension was a multicenter trial of African Americans with hypertensive kidney disease randomized to an angiotensin-converting enzyme inhibitor (ramipril), a β-blocker (metoprolol succinate), or a calcium channel blocker (amlodipine besylate). We compared the incidence of type 2 diabetes mellitus (DM) and the composite outcome of impaired fasting glucose orDM (IFG/DM) for the African American Study of Kidney Disease and Hypertension interventions. Methods: Cox regression models were used to evaluate (post hoc) the association of the randomized interventions and the relative risk (RR) of DM and IFG/DM and to assess the RR of DM and IFG/DM by several pre-randomization characteristics. Results: Among 1017 participants, 147 (14.5%) developed DM; 333 (42.9%) of 776 participants developed IFG/ DM. Respective DM event rates were 2.8%, 4.4%, and 4.5% per patient-year in the ramipril-, amlodipine-, and metoprolol-treated groups. The RRs of DM with ramipril treatment were 0.53 (P=.001) compared with metoprolol treatment and 0.49 (P=.003) compared with amlodipine treatment. Respective IFG/DM event rates were 11.3%, 13.3%, and 15.8% per patient-year in the ramipril-, amlodipine-, and metoprolol-treated groups. The RRs of IFG/DM with ramipril treatment were 0.64 (P

Original languageEnglish (US)
Pages (from-to)797-805
Number of pages9
JournalArchives of Internal Medicine
Volume166
Issue number7
DOIs
StatePublished - Apr 10 2006

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Ramipril
Kidney Diseases
Antihypertensive Agents
Amlodipine
Diabetes Mellitus
Metoprolol
Fasting
Incidence
Glucose
African Americans
Hypertension
Calcium Channel Blockers
Therapeutics
Random Allocation
Proportional Hazards Models
Angiotensin-Converting Enzyme Inhibitors
Type 2 Diabetes Mellitus
Multicenter Studies

ASJC Scopus subject areas

  • Internal Medicine

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Differing effects of antihypertensive drugs on the incidence of diabetes mellitus among patients with hypertensive kidney disease. / Thornley-Brown, Denyse; Wang, Xuelei; Wright, Jackson T.; Randall, Otelio S.; Miller, Edgar R; Lash, James P.; Gassman, Jennifer; Contreras, Gabriel; Appel, Lawrence; Agodoa, Lawrence Y.; Cheek, DeAnna.

In: Archives of Internal Medicine, Vol. 166, No. 7, 10.04.2006, p. 797-805.

Research output: Contribution to journalArticle

Thornley-Brown, D, Wang, X, Wright, JT, Randall, OS, Miller, ER, Lash, JP, Gassman, J, Contreras, G, Appel, L, Agodoa, LY & Cheek, D 2006, 'Differing effects of antihypertensive drugs on the incidence of diabetes mellitus among patients with hypertensive kidney disease', Archives of Internal Medicine, vol. 166, no. 7, pp. 797-805. https://doi.org/10.1001/archinte.166.7.797
Thornley-Brown, Denyse ; Wang, Xuelei ; Wright, Jackson T. ; Randall, Otelio S. ; Miller, Edgar R ; Lash, James P. ; Gassman, Jennifer ; Contreras, Gabriel ; Appel, Lawrence ; Agodoa, Lawrence Y. ; Cheek, DeAnna. / Differing effects of antihypertensive drugs on the incidence of diabetes mellitus among patients with hypertensive kidney disease. In: Archives of Internal Medicine. 2006 ; Vol. 166, No. 7. pp. 797-805.
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AU - Wang, Xuelei

AU - Wright, Jackson T.

AU - Randall, Otelio S.

AU - Miller, Edgar R

AU - Lash, James P.

AU - Gassman, Jennifer

AU - Contreras, Gabriel

AU - Appel, Lawrence

AU - Agodoa, Lawrence Y.

AU - Cheek, DeAnna

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N2 - Background: The African American Study of Kidney Disease and Hypertension was a multicenter trial of African Americans with hypertensive kidney disease randomized to an angiotensin-converting enzyme inhibitor (ramipril), a β-blocker (metoprolol succinate), or a calcium channel blocker (amlodipine besylate). We compared the incidence of type 2 diabetes mellitus (DM) and the composite outcome of impaired fasting glucose orDM (IFG/DM) for the African American Study of Kidney Disease and Hypertension interventions. Methods: Cox regression models were used to evaluate (post hoc) the association of the randomized interventions and the relative risk (RR) of DM and IFG/DM and to assess the RR of DM and IFG/DM by several pre-randomization characteristics. Results: Among 1017 participants, 147 (14.5%) developed DM; 333 (42.9%) of 776 participants developed IFG/ DM. Respective DM event rates were 2.8%, 4.4%, and 4.5% per patient-year in the ramipril-, amlodipine-, and metoprolol-treated groups. The RRs of DM with ramipril treatment were 0.53 (P=.001) compared with metoprolol treatment and 0.49 (P=.003) compared with amlodipine treatment. Respective IFG/DM event rates were 11.3%, 13.3%, and 15.8% per patient-year in the ramipril-, amlodipine-, and metoprolol-treated groups. The RRs of IFG/DM with ramipril treatment were 0.64 (P

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