Diabetes with hypertension medical therapy: Difference between revisions
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* Study results: Losartan was found to be more effective than atenolol in reducing composite endpoints like cardiovascular morbidity and all causes mortality in patients with hypertension, diabetes, and left-ventricular hypertrophy. | * Study results: Losartan was found to be more effective than atenolol in reducing composite endpoints like cardiovascular morbidity and all causes mortality in patients with hypertension, diabetes, and left-ventricular hypertrophy. | ||
===Study name: Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial, ('''[[FACET]]'''), 1998=== | ===Study name: Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial, ('''[[FACET]]'''), 1998 <ref name="pmid9571349">{{cite journal| author=Tatti P, Pahor M, Byington RP, Di Mauro P, Guarisco R, Strollo G et al.| title=Outcome results of the Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial (FACET) in patients with hypertension and NIDDM. | journal=Diabetes Care | year= 1998 | volume= 21 | issue= 4 | pages= 597-603 | pmid=9571349 | doi= | pmc= | url= }} </ref>=== | ||
* Study design: Open label, randomized trial | * Study design: Open label, randomized trial | ||
* Sample size: 380 [[hypertension|hypertensive]] diabetics patient | * Sample size: 380 [[hypertension|hypertensive]] diabetics patient | ||
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* Inclusion criteria- [[NIDDM]] and hypertension (SBP > 140 mmHg or DBP > 90 mmHg). | * Inclusion criteria- [[NIDDM]] and hypertension (SBP > 140 mmHg or DBP > 90 mmHg). | ||
* Exclusion criteria- History of [[coronary heart disease]] or [[stroke]], serum [[creatinine]] > 1.5 mg/dl, [[albuminuria]] > 40 micrograms/min, and use of lipid-lowering drugs, [[aspirin]], or antihypertensive agents other than [[beta-blocker]]s or [[diuretic]]s. | * Exclusion criteria- History of [[coronary heart disease]] or [[stroke]], serum [[creatinine]] > 1.5 mg/dl, [[albuminuria]] > 40 micrograms/min, and use of lipid-lowering drugs, [[aspirin]], or antihypertensive agents other than [[beta-blocker]]s or [[diuretic]]s. | ||
* Study results: Fosinopril lowered the risk of the composite endpoints of acute [[myocardial infarction]], stroke, or hospitalization due to [[angina]] more compared to amlodipine (hazards ratio = 0.49, 95% CI = 0.26-0.95). However, no significant difference in total [[serum cholesterol]], [[HDL cholesterol]], [[HbA1c]], fasting serum glucose, or plasma insulin was found | * Study results: Fosinopril lowered the risk of the composite endpoints of acute [[myocardial infarction]], stroke, or hospitalization due to [[angina]] more compared to amlodipine (hazards ratio = 0.49, 95% CI = 0.26-0.95). However, no significant difference in total [[serum cholesterol]], [[HDL cholesterol]], [[HbA1c]], fasting serum glucose, or plasma insulin was found. | ||
==References== | ==References== | ||
Revision as of 15:59, 15 September 2011
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]
Overview
Hypertension is a common co-morbidity associated with patients of diabetes, especially type 2 diabetes. Proper management of both these conditions are important to prevent future chronic complications like cardiovascular, nephrology and other complications.
Supportive trial data
Study name:LIFE study, 2002[1]
- Study design: Double blind, randomised, parallel-group trial
- Sample size: 1195 patients with diabetes, hypertension, left-ventricular hypertrophy on electrocardiograms
- Drugs: Losartan or Atenolol
- Study period: 4 years
- Study results: Losartan was found to be more effective than atenolol in reducing composite endpoints like cardiovascular morbidity and all causes mortality in patients with hypertension, diabetes, and left-ventricular hypertrophy.
Study name: Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial, (FACET), 1998 [2]
- Study design: Open label, randomized trial
- Sample size: 380 hypertensive diabetics patient
- Drugs: Fosinopril (20 mg/day) or amlodipine (10 mg/day)
- Study period: 3.5 years
- Inclusion criteria- NIDDM and hypertension (SBP > 140 mmHg or DBP > 90 mmHg).
- Exclusion criteria- History of coronary heart disease or stroke, serum creatinine > 1.5 mg/dl, albuminuria > 40 micrograms/min, and use of lipid-lowering drugs, aspirin, or antihypertensive agents other than beta-blockers or diuretics.
- Study results: Fosinopril lowered the risk of the composite endpoints of acute myocardial infarction, stroke, or hospitalization due to angina more compared to amlodipine (hazards ratio = 0.49, 95% CI = 0.26-0.95). However, no significant difference in total serum cholesterol, HDL cholesterol, HbA1c, fasting serum glucose, or plasma insulin was found.
References
- ↑ Lindholm LH, Ibsen H, Dahlöf B, Devereux RB, Beevers G, de Faire U; et al. (2002). "Cardiovascular morbidity and mortality in patients with diabetes in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol". Lancet. 359 (9311): 1004–10. doi:10.1016/S0140-6736(02)08090-X. PMID 11937179. Review in: ACP J Club. 2002 Nov-Dec;137(3):87
- ↑ Tatti P, Pahor M, Byington RP, Di Mauro P, Guarisco R, Strollo G; et al. (1998). "Outcome results of the Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial (FACET) in patients with hypertension and NIDDM". Diabetes Care. 21 (4): 597–603. PMID 9571349.