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Valsartan Reduces Chance of Diabetes in High-Risk Hypertensive Patients

By Ed Susman

SAN FRANCISCO, CA -- May 19, 2005 -- A new analysis of a major clinical trial shows that hypertensive patients treated with the angiotensin receptor blocker valsartan have a reduced risk of developing diabetes compared with patients who receive the calcium channel blocker amlodipine. The findings were presented here May 17^th at the 20^th Annual Scientific Meeting and Exposition of the American Society of Hypertension.

"These new results should help physicians as they select anti-hypertensive agents for their patients, especially for those at higher risk of developing diabetes," said Kenneth Jamerson, MD, professor of internal medicine at the University of Michigan in Ann Arbor, Michigan, United States. "Since we know from other studies that other hypertension medications such as diuretics come with a higher risk of diabetes, this result is especially interesting."

In comparing valsartan (Diovan) against the calcium channel blocker amlodipine (Norvasc), Dr. Jamerson and colleagues determined that patients taking valsartan had a 23% lower risk of developing diabetes during the four or more years of the study. The two drugs had previously been shown to be roughly equivalent in reducing the risk of heart attack and stroke.

The Valsartan Antihypertensive Long-Term Use Evaluation (VALUE) study enrolled 15,313 patients at 942 sites in 31 countries. Approximately 10,000 of these patients were non-diabetic at the start of the trial. All patients were hypertensive, over age 50, and at high risk for having a cardiac event.

By the end of four or more years of follow-up, 11.5% of the patients taking valsartan had developed diabetes, compared with 14.5% of patients taking amlodipine. According to Dr. Jamerson, the difference represented a relative risk reduction of 23%, and that difference reached statistical significance at the P < .0001 level.

The new in-depth analysis of data from the two groups of patients shows that the difference in diabetes onset risk appears to be attributable to valsartan and not to other underlying factors, said Dr. Jamerson.

But the researchers did determine that certain risk factors made some patients more likely to develop diabetes; the more of these risk factors a patient had, the more protective was the effect of valsartan.

Hyperglycemia, faster heart rate, high body mass index, the concurrent use of a diuretic drug and beta blocker drug, non-white race, and younger age were all associated with a higher risk of developing diabetes in all VALUE participants. But after all these variables were taken into account, patients who took valsartan had a lower chance of developing diabetes.

"We know many factors increase the risk of diabetes, but valsartan appears to be important in that it provides protection against diabetes," said Dr. Jamerson. "Many patients with hypertension are also obese and have other risk factors that predispose them to develop diabetes. This trial adds to the armamentarium that physicians can choose from when treating patients with high diabetes risk."

The trial was sponsored by Novartis, which markets Diovan.


[Presentation title: Effects of Valsartan Preventing the Development of Type 2 Diabetes in High Risk Hypertensive Patients: Analysis From the VALUE Trial.]

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