Effect of ramipril on the incidence of diabetes.
BACKGROUND: Previous studies have suggested that blockade of the renin-angiotensin system may prevent diabetes in people with cardiovascular disease or hypertension. METHODS: In a double-blind, randomized clinical trial with a 2-by-2 factorial design, we randomly assigned 5269 participants without...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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2006
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| _version_ | 1797079911740997632 |
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| author | Bosch, J Yusuf, S Gerstein, H Pogue, J Sheridan, P Dagenais, G Diaz, R Avezum, A Lanas, F Probstfield, J Fodor, G Holman, R |
| author_facet | Bosch, J Yusuf, S Gerstein, H Pogue, J Sheridan, P Dagenais, G Diaz, R Avezum, A Lanas, F Probstfield, J Fodor, G Holman, R |
| author_sort | Bosch, J |
| collection | OXFORD |
| description | BACKGROUND: Previous studies have suggested that blockade of the renin-angiotensin system may prevent diabetes in people with cardiovascular disease or hypertension. METHODS: In a double-blind, randomized clinical trial with a 2-by-2 factorial design, we randomly assigned 5269 participants without cardiovascular disease but with impaired fasting glucose levels (after an 8-hour fast) or impaired glucose tolerance to receive ramipril (up to 15 mg per day) or placebo (and rosiglitazone or placebo) and followed them for a median of 3 years. We studied the effects of ramipril on the development of diabetes or death, whichever came first (the primary outcome), and on secondary outcomes, including regression to normoglycemia. RESULTS: The incidence of the primary outcome did not differ significantly between the ramipril group (18.1%) and the placebo group (19.5%; hazard ratio for the ramipril group, 0.91; 95% confidence interval [CI], 0.81 to 1.03; P=0.15). Participants receiving ramipril were more likely to have regression to normoglycemia than those receiving placebo (hazard ratio, 1.16; 95% CI, 1.07 to 1.27; P=0.001). At the end of the study, the median fasting plasma glucose level was not significantly lower in the ramipril group (102.7 mg per deciliter [5.70 mmol per liter]) than in the placebo group (103.4 mg per deciliter [5.74 mmol per liter], P=0.07), though plasma glucose levels 2 hours after an oral glucose load were significantly lower in the ramipril group (135.1 mg per deciliter [7.50 mmol per liter] vs. 140.5 mg per deciliter [7.80 mmol per liter], P=0.01). CONCLUSIONS: Among persons with impaired fasting glucose levels or impaired glucose tolerance, the use of ramipril for 3 years does not significantly reduce the incidence of diabetes or death but does significantly increase regression to normoglycemia. (ClinicalTrials.gov number, NCT00095654 [ClinicalTrials.gov].). |
| first_indexed | 2024-03-07T00:52:37Z |
| format | Journal article |
| id | oxford-uuid:86e8cd3c-4e90-4cd7-9bf5-e221a8ca1d76 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T00:52:37Z |
| publishDate | 2006 |
| record_format | dspace |
| spelling | oxford-uuid:86e8cd3c-4e90-4cd7-9bf5-e221a8ca1d762022-03-26T22:07:18ZEffect of ramipril on the incidence of diabetes.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:86e8cd3c-4e90-4cd7-9bf5-e221a8ca1d76EnglishSymplectic Elements at Oxford2006Bosch, JYusuf, SGerstein, HPogue, JSheridan, PDagenais, GDiaz, RAvezum, ALanas, FProbstfield, JFodor, GHolman, R BACKGROUND: Previous studies have suggested that blockade of the renin-angiotensin system may prevent diabetes in people with cardiovascular disease or hypertension. METHODS: In a double-blind, randomized clinical trial with a 2-by-2 factorial design, we randomly assigned 5269 participants without cardiovascular disease but with impaired fasting glucose levels (after an 8-hour fast) or impaired glucose tolerance to receive ramipril (up to 15 mg per day) or placebo (and rosiglitazone or placebo) and followed them for a median of 3 years. We studied the effects of ramipril on the development of diabetes or death, whichever came first (the primary outcome), and on secondary outcomes, including regression to normoglycemia. RESULTS: The incidence of the primary outcome did not differ significantly between the ramipril group (18.1%) and the placebo group (19.5%; hazard ratio for the ramipril group, 0.91; 95% confidence interval [CI], 0.81 to 1.03; P=0.15). Participants receiving ramipril were more likely to have regression to normoglycemia than those receiving placebo (hazard ratio, 1.16; 95% CI, 1.07 to 1.27; P=0.001). At the end of the study, the median fasting plasma glucose level was not significantly lower in the ramipril group (102.7 mg per deciliter [5.70 mmol per liter]) than in the placebo group (103.4 mg per deciliter [5.74 mmol per liter], P=0.07), though plasma glucose levels 2 hours after an oral glucose load were significantly lower in the ramipril group (135.1 mg per deciliter [7.50 mmol per liter] vs. 140.5 mg per deciliter [7.80 mmol per liter], P=0.01). CONCLUSIONS: Among persons with impaired fasting glucose levels or impaired glucose tolerance, the use of ramipril for 3 years does not significantly reduce the incidence of diabetes or death but does significantly increase regression to normoglycemia. (ClinicalTrials.gov number, NCT00095654 [ClinicalTrials.gov].). |
| spellingShingle | Bosch, J Yusuf, S Gerstein, H Pogue, J Sheridan, P Dagenais, G Diaz, R Avezum, A Lanas, F Probstfield, J Fodor, G Holman, R Effect of ramipril on the incidence of diabetes. |
| title | Effect of ramipril on the incidence of diabetes. |
| title_full | Effect of ramipril on the incidence of diabetes. |
| title_fullStr | Effect of ramipril on the incidence of diabetes. |
| title_full_unstemmed | Effect of ramipril on the incidence of diabetes. |
| title_short | Effect of ramipril on the incidence of diabetes. |
| title_sort | effect of ramipril on the incidence of diabetes |
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