Info Vka
13.1 vs 16.4
<0.0001
Modified from ref. 8 (see also refs. 9 and 10).
Modified from ref. 8 (see also refs. 9 and 10).
recently published Valsartan Antihypertensive Long-term Use Evaluation (VALUE) study (11) also showed that the ARB, valsartan, confers benefits in protecting against diabetes in comparison with the calcium channel blocker (CCB), amlodipine, with a highly significantly reduced risk of developing new type 2 diabetes during 5 yr of follow-up. A summary of evidence from clinical trials evidence to date is provided in Table 1.
Thus, a strong argument can already be made for the initial selection of these agents rather than diuretics or P-blockers alone, and now even CCBs (11). This applies particularly to patients with CV disease and hypertension, and probably also to individuals with uncomplicated hypertension.
However, the issue is not completely settled. First of all, we may need a more definitive study, such as the ongoing diabetes reduction approaches with ramipril and rosigli-tazone medications (dream) study, which will assess the effects of ramipril and rosiglitazone in patients at high risk of developing diabetes. We also need more information on the mechanisms of action of antihypertensives because details are not yet clearly understood.
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