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Risk of diabetes in a real-world setting among patients initiating antihypertensive therapy with valsartan or amlodipine

Journal of Human Hypertension volume 21, pages 374–380 (2007)Cite this article

Abstract

In the Valsartan Antihypertensive Long-Term Use Evaluation (VALUE) trial, the risk of new-onset diabetes was reported to be 23% lower among patients initiating therapy with valsartan versus amlodipine. The objective of our study was to examine whether this finding is generalizable to ‘real-world’ clinical practice. A retrospective cohort design and a large US health insurance database were employed for analyses. Study subjects included all hypertensive patients, aged ⩾35 years, who were free from diabetes and who initiated treatment with valsartan (n=9999) or amlodipine (n=18 698) between January 1999 and March 2005. Unadjusted absolute risks of diabetes were 21.4 (95% confidence interval (CI) 18.9–24.3) and 26.3 (95% CI 24.3–28.3) per 1000 patient-years for valsartan and amlodipine, respectively; the corresponding relative risk (RR) for valsartan was 0.82 (95% CI 0.70–0.94). Multivariate analyses – controlling for age, sex, presence of hypercholesterolemia, cardiovascular disease and kidney disease, and pretreatment medical care expenditures – yielded similar results (RR=0.79, 95% CI 0.68–0.92). Our study thus corroborates the finding from VALUE that diabetes risk is lower for patients who receive valsartan versus amlodipine, and extends this finding to a ‘real-world’ setting.

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Acknowledgements

Funding for this research was provided by Novartis Pharma AG.

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Authors and Affiliations

  1. Policy Analysis Inc. (PAI), Brookline, MA, USA

    D Weycker, J Edelsberg & G Oster

  2. Novartis Pharma AG, Basel, Switzerland

    G Vincze

  3. Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA

    S E Kjeldsen & K Jamerson

  4. Department of Cardiology, Ullevaal University Hospital, Oslo, Norway

    S E Kjeldsen

  5. Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA

    Z M Khan

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  1. D Weycker
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  2. J Edelsberg
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  4. S E Kjeldsen
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  5. K Jamerson
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  6. Z M Khan
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  7. G Oster
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Correspondence to D Weycker.

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Weycker, D., Edelsberg, J., Vincze, G. et al. Risk of diabetes in a real-world setting among patients initiating antihypertensive therapy with valsartan or amlodipine. J Hum Hypertens 21, 374–380 (2007). https://doi.org/10.1038/sj.jhh.1002159

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