The Effect of Nisoldipine as Compared with Enalapril on Cardiovascular Outcomes in Patients with Non-Insulin-Dependent Diabetes and Hypertension
Raymond O. Estacio, M.D., Barrett W. Jeffers, M.S., William R. Hiatt, M.D., Stacy L. Biggerstaff, M.S., Nancy Gifford, R.N., and Robert W. Schrier, M.D.
Background It has recently been reported that the use of calcium-channelblockers for hypertension may be associated with an increasedrisk of cardiovascular complications. Because this issue remainscontroversial, we studied the incidence of such complicationsin patients with non-insulin-dependent diabetes mellitus andhypertension who were randomly assigned to treatment with eitherthe calcium-channel blocker nisoldipine or the angiotensin-converting–enzymeinhibitor enalapril as part of a larger study.
Methods The Appropriate Blood Pressure Control in Diabetes (ABCD)Trial is a prospective, randomized, blinded trial comparingthe effects of moderate control of blood pressure (target diastolicpressure, 80 to 89 mm Hg) with those of intensive control ofblood pressure (target diastolic pressure, 75 mm Hg) on theincidence and progression of complications of diabetes. Thestudy also compared nisoldipine with enalapril as a first-lineantihypertensive agent in terms of the prevention and progressionof complications of diabetes. In the current study, we analyzeddata on a secondary end point (the incidence of myocardial infarction)in the subgroup of patients in the ABCD Trial who had hypertension.
Results Analysis of the 470 patients in the trial who had hypertension(base-line diastolic blood pressure, >90 mm Hg) showed similarcontrol of blood pressure, blood glucose and lipid concentrations,and smoking behavior in the nisoldipine group (235 patients)and the enalapril group (235 patients) throughout five yearsof follow-up. Using a multiple logistic-regression model withadjustment for cardiac risk factors, we found that nisoldipinewas associated with a higher incidence of fatal and nonfatalmyocardial infarctions (a total of 25) than enalapril (total,5) (risk ratio, 9.5; 95 percent confidence interval, 2.3 to21.4).
Conclusions In this population of patients with diabetes andhypertension, we found a significantly higher incidence of fataland nonfatal myocardial infarction among those assigned to therapywith the calcium-channel blocker nisoldipine than among thoseassigned to receive enalapril. Since our findings are basedon a secondary end point, they will require confirmation.
Cardiovascular disease accounts for 40 percent of overall mortalityin the United States1 and is the leading cause of death amongpersons with non-insulin-dependent diabetes mellitus (NIDDM).2,3Strategies to reduce this risk include the appropriate treatmentof hypertension. However, the choice of antihypertensive agentsmay also affect the risk of cardiovascular events. In this regard,the angiotensin-converting–enzyme (ACE) inhibitors havebeen demonstrated to increase survival after an acute myocardialinfarction4,5,6 and among patients with congestive heart failure.7,8,9Calcium-channel–blocking drugs are also indicated forthe treatment of a variety of cardiovascular diseases, includingangina pectoris, systemic and pulmonary hypertension, certaincardiac arrhythmias, and Raynaud's phenomenon.10 ACE inhibitorshave been shown to be effective antihypertensive drugs for bothpatients with diabetes and those without diabetes. Studies havedemonstrated the efficacy of ACE inhibitors in slowing the progressionof diabetic nephropathy in patients with insulin-dependent diabetesmellitus (IDDM) and possibly those with NIDDM.11,12,13,14,15At present, calcium-channel blockers are among the most frequentlyprescribed antihypertensive medications in the country.10 However,although calcium-channel blockers are an important part of thetherapeutic armamentarium against cardiovascular diseases, concernhas been aroused about these drugs, particularly the short-actingdihydropyridine derivatives. Recent studies have focused attentionon the possibility that some of these agents may increase therisk of cardiovascular events in patients without diabetes.16,17,18
The Appropriate Blood Pressure Control in Diabetes (ABCD) Trialwas designed to test the primary hypothesis that intensive blood-pressurecontrol, as compared with moderate control, would prevent orslow the progression of diabetic nephropathy, neuropathy, retinopathy,and cardiovascular events.19 The secondary hypothesis was thata long-acting dihydropyridine calcium-channel blocker (nisoldipine)would have an effect equivalent to that of an ACE inhibitor(enalapril) in preventing or delaying the progression of thesecomplications. The present study grew out of the recommendationof the Data and Safety Monitoring Committee that nisoldipinetreatment be terminated in the subgroup of patients with hypertension.The committee's recommendation and this report were based ondata from a mean of five years of follow-up on the effects ofnisoldipine and enalapril on the incidence of cardiovascularevents among patients with hypertension and NIDDM in the ABCDTrial. In our report we focus only on the findings of the interimanalysis of data on the cohort with hypertension; the entirestudy is expected to be completed on June 1, 1998.
Methods
Study Design
After the cohorts with and without hypertension were prospectivelydefined, patients were randomly assigned to moderate or intensiveantihypertensive treatment. Within the moderate-treatment andintensive-treatment groups, patients were further randomly assignedto receive either nisoldipine or enalapril as a first-line antihypertensivemedication. The primary objective of the study was to determinethe relative effects of moderate and intensive blood-pressurecontrol on the change in the creatinine clearance rate amongboth the normotensive and the hypertensive patients, all ofwhom had NIDDM. The design of the ABCD Trial has been describedpreviously.19 The study was approved by the institutional reviewboard of the University of Colorado Health Sciences Center.All patients gave written informed consent.
Study Participants
The patients enrolled in the ABCD Trial were between the agesof 40 and 74 years at the time of recruitment and were identifiedaccording to diagnosis-related groups from the pharmacy andbilling lists of participating health care systems in the Denvermetropolitan area. All patients in the ABCD Trial had NIDDM,diagnosed according to criteria based on those of the WorldHealth Organization report of 1985.20 All enrolled subjectshad diastolic blood pressure of 80 mm Hg or higher and werereceiving no antihypertensive medications at the time of randomization.Patients were excluded if they had a known allergy to dihydropyridinecalcium-channel blockers or ACE inhibitors, had had a myocardialinfarction or cerebrovascular accident within the previous sixmonths, had undergone coronary-artery bypass surgery withinthe previous three months, had had unstable angina pectoriswithin the previous six months, had New York Heart Associationclass III or IV congestive heart failure, had an absolute needfor therapy with ACE inhibitors or calcium-channel blockers,were receiving hemodialysis or peritoneal dialysis, or had aserum creatinine concentration greater than 3 mg per deciliter(265 µmol per liter).
Base-Line Evaluation
During a single-blind placebo run-in period lasting 7 to 11weeks, all base-line studies were performed.19 Cardiovasculardisease was identified at base line in patients who met oneor more of the following criteria: (1) coronary artery disease,indicated by the patient's report of a previous myocardial infarction,coronary-artery bypass graft, or angioplasty, electrocardiographicfindings consistent with a previous myocardial infarction, ora base-line treadmill exercise test that was positive for cardiacischemia; (2) angina, identified by means of the Rose questionnaire21;(3) cerebrovascular accident, reported by the patient; (4) congestiveheart failure; (5) abnormal ankle–brachial index, definedas a value less than 0.9522; and (6) evidence of left ventricularhypertrophy on the base-line electrocardiogram. Details of thestudies performed have been reported previously.23
Randomization and Therapy
After the placebo run-in period, each patient's mean base-linediastolic blood pressure was determined at two separate visits.The study population was subsequently divided prospectivelyinto two cohorts, a group without hypertension (mean base-linediastolic blood pressure, 80 to 89 mm Hg) and a group with hypertension(mean base-line diastolic blood pressure, >90 mm Hg). Inthe normotensive cohort, patients were randomly assigned toone of two treatment strategies: intensive treatment with thegoal of decreasing the diastolic blood pressure by 10 mm Hgfrom the mean base-line value (with further random assignmentto receive either nisoldipine or enalapril), or moderate treatmentwith no intended change in the base-line diastolic blood pressure(these patients were thus randomly assigned to receive placebo).Thus, in the normotensive group, 50 percent of the patientsreceived placebo, 25 percent nisoldipine, and 25 percent enalapril.A similar approach was used for the patients with hypertension.Patients were randomly assigned either to intensive treatment,with a target diastolic blood pressure of 75 mm Hg, or to moderatetreatment, with a target diastolic blood pressure of 80 to 89mm Hg. Unlike the normotensive group, however, all the patientswith hypertension received active treatment (50 percent nisoldipineand 50 percent enalapril).
Patients assigned to active study medication received eithernisoldipine (Sular, Zeneca, Wilmington, Del.; 10 mg per day,with increases to 20, 40, and 60 mg per day, plus placebo forenalapril) or enalapril (Vasotec, Merck, Whitehouse Station,N.J.; 5 mg per day, with increases to 10, 20, and 40 mg perday, plus placebo for nisoldipine). The drugs and placebos wereadministered in a double-blind manner. If the single study medicationassigned did not achieve the target blood pressure, then open-labelantihypertensive medications were added in a stepwise fashionuntil the target blood pressure was achieved. The open-labelantihypertensive medications included metoprolol and hydrochlorothiazide.Additional antihypertensive medications were added at the discretionof the medical director of the study, but these did not includea calcium-channel blocker or ACE inhibitor.
End Points
In both the cohort with hypertension (470 patients) and thecohort without hypertension ( 480 patients), the primary endpoint was the effect of intensive or moderate blood-pressurecontrol on the change in the 24-hour creatinine clearance, whichwas assessed every six months.19 Secondary end points includedthe effect of intensive as compared with moderate blood-pressurecontrol on the incidence of cardiovascular events, retinopathy(determined by stereoscopic retinal photography24), clinicalneuropathy,25 urinary albumin excretion,26 and left ventricularhypertrophy (as measured by M-mode echocardiography27).
All cardiovascular events were reviewed by an independent end-pointscommittee whose members were blinded to the patients' assignedtreatment groups. Cardiovascular outcomes were defined as deathdue to cardiovascular events (sudden death, progressive heartfailure, fatal myocardial infarction, fatal arrhythmias, cerebrovascularaccidents, or ruptured aortic aneurysm); nonfatal myocardialinfarction; nonfatal cerebrovascular accident; heart failurerequiring hospital admission; or pulmonary infarction. Dataon all hospital admissions that appeared to be related to acardiovascular event were reviewed by the end-points committee.
The diagnosis of myocardial infarction was based on medicalrecords reviewed by the end-points committee. For myocardialinfarction to be diagnosed, the patient had to have at leasttwo of the following: a history of retrosternal pain, with orwithout radiation to the shoulder, arms, jaws, or abdomen, thatlasted at least 30 minutes and did not respond to nitroglycerinduring the attack; electrocardiographic abnormalities indicativeof myocardial infarction; and changes in the concentrationsof one or more of the enzymes creatine kinase, aspartate aminotransferase,and lactate dehydrogenase.
After 67 months of study, the Data and Safety Monitoring Committeeobserved a significant difference in the rate of cardiovascularevents between the subgroups of patients treated with the twostudy drugs in the hypertensive cohort only. On the basis ofthis information, the committee recommended the discontinuationof nisoldipine therapy among the patients with hypertensionand the continuation of blinded therapy among the normotensivepatients. This report focuses only on the findings in the hypertensivecohort.
Statistical Analysis
SAS software (SAS Institute, Cary, N.C.) was used for all statisticalanalyses. When examining cardiovascular end points (nonfatalmyocardial infarction, cerebrovascular accidents, congestiveheart failure requiring hospital admission, death from cardiovascularcauses, and the combined end point of nonfatal and fatal myocardialinfarction), we used chi-square analysis to examine the univariaterelation between each cardiovascular end point and the study-drugassignment. A multiple logistic-regression model was used toexamine the effect of the assigned drug, with adjustment forother known or suspected cardiovascular risk factors. In addition,a multiple logistic-regression model was used to test for aninteraction between the study-drug assignment and the blood-pressure–controlintervention. All values are reported as means ±SD.
A survival-analysis approach was also used to compare the survivalcurves between the patients randomly assigned to enalapril withthose randomly assigned to nisoldipine. The survival analyseswere performed in three ways: with Kaplan–Meier survivalcurves for groups of patients randomly assigned to the two studydrugs; with a proportional-hazards regression model incorporatingthe randomly assigned drug; and with a proportional-hazardsregression model incorporating a time-dependent variable accountingfor exposure to the study medication.
The first two approaches followed the intention-to-treat principle,whereas the third approach took into account the actual timeintervals during which study medication was received by eachpatient. The Kaplan–Meier survival analysis was performedaccording to the LIFETEST procedure (SAS version 6.12), whichcalculates a nonparametric estimate of the survival distribution.For the proportional-hazards regression models, we used thePHREG procedure (SAS version 6.12), which generates a semi-parametricregression analysis of survival data based on the Cox proportional-hazardsmodel and allows time-dependent covariates to be introducedinto the model.
Results
Table 1 shows the base-line characteristics of the subjectswith hypertension according to their random assignment to nisoldipineor enalapril. Patients assigned to receive enalapril had a significantlylower high-density lipoprotein (HDL) cholesterol concentration(P=0.03). As Table 2 shows, a higher percentage of patientsrandomly assigned to receive enalapril had an abnormal ankle–brachialindex (P = 0.008) and evidence of angina on the Rose questionnaire(P=0.02), as compared with those assigned to receive nisoldipine.
Table 2. Distribution of Complications at Base Line, According to Study Medication.
Figure 1 shows the level of blood-pressure control in the groupsgiven the two study medications throughout the study; no significantdifferences were seen. Ninety-nine patients in the enalaprilgroup took a beta-blocker, as compared with 89 patients in thenisoldipine group (P = 0.035). One hundred nineteen patientsassigned to enalapril took a diuretic agent, as did 93 assignedto nisoldipine (P=0.02). Figure 2 shows that the concentrationsof glycosylated hemoglobin and total cholesterol were similarin the patients assigned to the two study medications. Othermetabolic variables, such as the low-density lipoprotein cholesteroland triglyceride concentrations, the number of patients whosmoked, and the number of pack-years of smoking, also did notdiffer significantly between the patients assigned to enalapriland those assigned to nisoldipine.
Figure 1. Systolic and Diastolic Blood Pressure during the Study among Patients in the Intensive-Treatment and Moderate-Treatment Groups Who Were Assigned to Receive Nisoldipine or Enalapril as First-Line Antihypertensive Medication.
The numbers below each panel show the number of patients in the analysis.
Figure 2. Glycosylated Hemoglobin and Total Cholesterol Values in Patients Assigned to Receive Nisoldipine or Enalapril.
To convert values for total cholesterol to millimoles per liter, multiply by 0.02586. The numbers shown below the graph are the numbers of patients in the analysis.
Cardiovascular Events
In the enalapril group, there were 5 deaths due to cardiovasculardisease, as compared with 10 in the nisoldipine group (Table 3).There were fewer myocardial infarctions in the enalaprilgroup than in the nisoldipine group (nonfatal myocardial infarctions,5 vs. 22; P=0.001 by the chi-square test; fatal and nonfatalmyocardial infarctions combined, 5 vs. 25; P=0.001 by the chi-squaretest) (Table 3). The rate of myocardial infarction during thefive-year study period was nearly one per year in the enalaprilgroup as compared with roughly five per year in the nisoldipinegroup. This relation was maintained among both the patientsassigned to intensive treatment (12 fatal or nonfatal myocardialinfarctions among patients given nisoldipine, as compared with4 in the enalapril group; P=0.03 by the chi-square test) andthose assigned to moderate treatment (13 and 1, respectively;P=0.002 by the chi-square test). As Table 3 shows, the adjustedrisk ratio for the nisoldipine-treated patients as comparedwith those given enalapril was 7.0 (95 percent confidence interval,2.3 to 21.4) for the combined end point of fatal or nonfatalmyocardial infarction. In addition, a test for interaction betweenstudy-drug assignment and blood-pressure–control strategyshowed that no interaction was present. Two of the 5 patientswith myocardial infarction in the enalapril group had had aprevious myocardial infarction, noted at base line, as comparedwith 2 of the 25 patients in the nisoldipine group (P = 0.12).
Table 3. Logistic-Regression Analyses of Cardiovascular Outcomes and Total Deaths, According to Treatment Group.
In the Kaplan–Meier survival analyses, the survival curvesappeared to separate early and remained distinct. Both the log-ranktest and the Wilcoxon test (P<0.001) and the proportional-hazardsregression model (P<0.001) showed a significant differencebetween the two drugs. When a time-dependent covariate reflectingexposure to the drug was introduced into the model, the resultsdid not change (P<0.001). This finding indicates that patientstaking nisoldipine were more likely to have a myocardial infarctionand to have one earlier than patients taking enalapril.
Reasons for Discontinuation of the Study Medication
Table 4 shows the reasons for the discontinuation of the studymedication by 142 patients in the nisoldipine group and 129in the enalapril group (P = 0.225). Significantly more patientsdiscontinued nisoldipine than enalapril because of headaches(P = 0.009). Significantly more discontinued enalapril becauseof malaise or fatigue (P = 0.005) or uncontrolled hypertension(P = 0.04). Patients continued to receive the study medicationafter a myocardial infarction unless their primary care physicianrequested that it be discontinued.
Table 4. Reasons for Discontinuing the Study Medication.
Discussion
The ABCD Trial was designed to compare the effects of blood-pressurecontrol at different intensities and of different types of antihypertensivemedications on complications of diabetes. The intention-to-treatanalyses of the data from a mean of five years of follow-upof the cohort with hypertension demonstrated a significantlylower rate of fatal and nonfatal myocardial infarctions amongthe patients randomly assigned to the ACE inhibitor enalaprilthan among those assigned to the calcium-channel blocker nisoldipine.
Since the findings were based on a secondary end point of thestudy, the results should be interpreted cautiously. Nonetheless,there was a significantly lower incidence of myocardial infarctionin the enalapril group, despite the potentially higher base-linerisk of cardiovascular events in that group. Specifically, patientsrandomly assigned to receive enalapril had lower HDL cholesterolconcentrations and a higher prevalence of an abnormal ankle–brachialindex, which has been shown to be an independent predictor ofdeath from cardiovascular causes,28,29 on entry into the study.Moreover, the difference between the two study medications wasstill striking after adjustment for other variables that mayinfluence the incidence of cardiovascular end points.
Another confounding variable that may have affected our resultswas the percentage of patients who discontinued the assignedstudy medication. The rate of discontinuation was not significantlydifferent for the two drugs. In an attempt to address this concern,we performed time-to-event analyses that also included a time-dependentcovariate reflecting exposure to the drug. The results indicatedthat the survival curves for the two drugs differed significantly.Not only were patients assigned to enalapril less likely tohave a myocardial infarction, but the time to a first eventwas longer than among the patients assigned to nisoldipine,thus further corroborating the results. The current report doesnot include findings in the normotensive cohort of the study,since the Data and Safety Monitoring Committee did not finda significant difference between the patients assigned to thetwo medications with respect to cardiovascular events. By thedesign of the study, 50 percent of the normotensive patientswere receiving the study medication and 50 percent placebo.Thus, only 25 percent of the patients without hypertension werereceiving nisoldipine, and 25 percent were receiving enalapril;the power of this portion of the study to detect significantdifferences was therefore limited. This portion of the studyis still ongoing.
Despite their potential benefits, much controversy has arisenrecently regarding calcium-channel blockers.30,31,32,33,34 Anumber of recent retrospective studies have demonstrated anassociation between the use of calcium-channel blockers (specificallynifedipine) and cardiovascular morbidity.16,17 Thus, it is importantto consider whether enalapril reduces the risk of myocardialinfarction, whether nisoldipine increases the risk of myocardialinfarction, or whether a combination of these effects occurs.Although comparisons with historical controls are not ideal,the rate of myocardial infarction among patients with NIDDMwho were randomly assigned to therapy with nisoldipine in ourstudy (10 percent over a period of five years) is not significantlydifferent from that in other recent studies of patients withNIDDM (6 to 14 percent over a five-year period).35,36,37 Therefore,it is plausible that our findings resulted from a protectiveeffect of enalapril. It should be stressed, however, that inthe present study, we cannot distinguish among a deleteriouseffect of nisoldipine, a protective effect of enalapril, anda combination of both as the reason for the difference we observed.
In summary, a prospective, randomized, blinded clinical studyin a population of patients with NIDDM and hypertension demonstratedthat treatment with enalapril for a mean of five years was associatedwith a lower incidence of myocardial infarction than was treatmentwith nisoldipine for the same period. Since our findings arebased on data on a secondary end point, the conclusions regardingthe use of calcium-channel blockers and ACE inhibitors in patientswith NIDDM must be evaluated on the basis of the results ofother clinical trials. In any case, our data indicate that anACE inhibitor is the preferred antihypertensive agent, ratherthan a dihydropyridine calcium-channel blocker, for the preventionof cardiovascular complications, specifically myocardial infarction,in patients with NIDDM.
Supported by the Bayer Pharmaceutical Company and by a grant(DK50298-02) from the National Institute of Diabetes and Digestiveand Kidney Diseases. Dr. Hiatt is the recipient of an AcademicAward in Vascular Disease from the National Institutes of Health.
We are indebted to the members of the Data and Safety MonitoringCommittee for their guidance: Paul W. Whelton, M.D., TulaneUniversity, New Orleans; Roger Sherwin, M.D., University ofMaryland, Baltimore; Ralph D'Agostino, Sr., Ph.D., Boston University,Boston; and Kevin Higgins, M.D., Bayer Pharmaceuticals, WestHaven, Conn.
Source Information
From the Colorado Prevention Center (R.O.E., B.W.J., W.R.H., S.L.B., N.G., R.W.S.); the Division of General Internal Medicine (R.O.E.), the Division of Renal Diseases and Hypertension (B.W.J., N.G., R.W.S.), the Divisions of Geriatrics and Cardiology (W.R.H.), Department of Medicine, and the Section of Vascular Medicine (W.R.H.), University of Colorado Health Sciences Center; and the Department of Community Health Services, Denver Health (R.O.E.) — all in Denver.
Address reprint requests to Dr. Schrier at the Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado Health Sciences Center, 4200 E. Ninth Ave., Box B-178, Denver, CO 80262.
References
National Center for Health Statistics. Advance report of final mortality statistics, 1986. Mon Vital Stat Rep 1988;37:Suppl:1-56.
Panzram G. Mortality and survival in type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia 1987;30:123-131. [Erratum, Diabetologia 1987;30:364.] [CrossRef][Medline]
Moss SE, Klein R, Klein BE. Cause-specific mortality in a population-based study of diabetes. Am J Public Health 1991;81:1158-1162. [Free Full Text]
Pfeffer MA, Braunwald E, Moyé LA, et al. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction: results of the Survival and Ventricular Enlargement Trial: the SAVE Investigators. N Engl J Med 1992;327:669-677. [Abstract]
ISIS-4 (Fourth International Study of Infarct Survival) Collaborative Group. ISIS-4: a randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58 050 patients with suspected acute myocardial infarction. Lancet 1995;345:669-685. [CrossRef][Medline]
Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico. GISSI-3: effects of lisinopril and transdermal glyceryl trinitrate singly and together on 6-week mortality and ventricular function after acute myocardial infarction. Lancet 1994;343:1115-1122. [Medline]
The CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure: results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med 1987;316:1429-1435. [Abstract]
The SOLVD Investigators. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med 1992;327:685-691. [Abstract]
Cohn JN. The management of chronic heart failure. N Engl J Med 1996;335:490-498. [Free Full Text]
Manolio TA, Cutler JA, Furberg CD, Psaty BM, Whelton PK, Applegate WB. Trends in pharmacologic management of hypertension in the United States. Arch Intern Med 1995;155:829-837. [Free Full Text]
Parving HH. Effects of ACE inhibitors on renal function in incipient and overt diabetic nephropathy. J Diabetes Complications 1996;10:133-135. [CrossRef][Medline]
Lewis EJ. Angiotensin-converting enzyme inhibition in type I diabetic nephropathy. Contrib Nephrol 1996;118:206-213. [Medline]
Maschio G, Alberti D, Janin G, et al. Effect of the angiotensin-converting-enzyme inhibitor benazepril on the progression of chronic renal insufficiency. N Engl J Med 1996;334:939-945. [Free Full Text]
Ravid M, Lang R, Rachmani R, Lishner M. Long-term renoprotective effect of angiotensin-converting enzyme inhibition in non-insulin-dependent diabetes mellitus: a 7-year follow-up study. Arch Intern Med 1996;156:286-289. [Free Full Text]
Parving HH, Rossing P, Hommel E, Smidt UM. Angiotensin-converting enzyme inhibition in diabetic nephropathy: ten years' experience. Am J Kidney Dis 1995;26:99-107. [Medline]
Psaty BM, Heckbert SR, Koepsell TD, et al. The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA 1995;274:620-625. [Free Full Text]
Furberg CD, Psaty BM, Meyer JV. Nifedipine: dose-related increase in mortality in patients with coronary heart disease. Circulation 1995;92:1326-1331. [Free Full Text]
Borhani NO, Mercuri M, Borhani PA, et al. Final outcome results of the Multicenter Isradipine Diuretic Atherosclerosis Study (MIDAS): a randomized controlled trial. JAMA 1996;276:785-791. [Free Full Text]
Savage S, Johnson Nagel N, Estacio RO, et al. The ABCD (Appropriate Blood Pressure Control in Diabetes) trial: rationale and design of a trial of hypertension control (moderate or intensive) in type II diabetes. Online J Curr Clin Trials 1993 Nov 24;Doc. No. 104:[6250 words; 128 paragraphs].
Diabetes mellitus: report of a WHO study group. WHO Tech Rep Ser 1985;727:7-113.
Heyden S, Bartel AG, Tabesh E, et al. Angina pectoris and the Rose questionnaire. Arch Intern Med 1971;128:961-964. [Free Full Text]
Hiatt WR, Marshall JA, Baxter J, et al. Diagnostic methods for peripheral arterial disease in the San Luis Valley Diabetes Study. J Clin Epidemiol 1990;43:597-606. [CrossRef][Medline]
Estacio RO, Savage S, Nagel NJ, Schrier RW. Baseline characteristics of participants in the Appropriate Blood Pressure Control in Diabetes trial. Control Clin Trials 1996;17:242-257. [CrossRef][Medline]
Early Treatment Diabetic Retinopathy Study Research Group. Grading diabetic retinopathy from stereoscopic color fundus photographs -- an extension of the modified Airlie House classification: ETDRS report number 10. Ophthalmology 1991;98:Suppl:786-806. [Medline]
Report and recommendations of the San Antonio conference on diabetic neuropathy. Ann Neurol 1988;24:99-104. [CrossRef][Medline]
Mogensen CE. Microalbuminuria in diabetic renal disease. In: Mogensen CE, Standl E, eds. Prevention and treatment of diabetic late complications. New York: Walter de Gruyter, 1989:41-73.
Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man: anatomic validation of the method. Circulation 1977;55:613-618. [Free Full Text]
Kornitzer M, Dramaix M, Sobolski J, Degre S, De Backer G. Ankle/arm pressure index in asymptomatic middle-aged males: an independent predictor of ten-year coronary heart disease mortality. Angiology 1995;46:211-219.
McKenna M, Wolfson S, Kuller L. The ratio of ankle and arm arterial pressure as an independent predictor of mortality. Atherosclerosis 1991;87:119-128. [CrossRef][Medline]
Glasser SP, Ripa S, Garland WT, et al. Antianginal and antiischemic efficacy of monotherapy extended-release nisoldipine (Coat Core) in chronic stable angina. J Clin Pharmacol 1995;35:780-784. [Abstract]
Heublein B, Amende I, Blanke PM, Baunack-Frost AR, Breuer HW. Nisoldipine versus isosorbide dinitrate in coronary heart disease: result of a double-masked study. Clin Ther 1996;18:448-459. [CrossRef][Medline]
Weinstein DB, Heider JG. Protective action of calcium channel antagonists in atherogenesis and experimental vascular injury. Am J Hypertens 1989;2:205-212. [Medline]
Lichtlen PR, Hugenholtz PG, Rafflenbeul W, Hecker H, Jost S, Deckers JW. Retardation of angiographic progression of coronary artery disease by nifedipine: results of the International Nifedipine Trial on Antiatherosclerotic Therapy (INTACT). Lancet 1990;335:1109-1113. [CrossRef][Medline]
Waters D, Lesperance J. Interventions that beneficially influence the evolution of coronary atherosclerosis: the case for calcium channel blockers. Circulation 1992;86:Suppl III:III-111.
Janka HU, Dirschedl P. Systolic blood pressure as a predictor for cardiovascular disease in diabetes: a 5-year longitudinal study. Hypertension 1985;7:II-90.
Koskinen P, Manttari M, Manninen V, Huttunen JK, Heinonen OP, Frick MH. Coronary heart disease incidence in NIDDM patients in the Helsinki Heart Study. Diabetes Care 1992;15:820-825. [Abstract]
Kuusisto J, Mykkanen L, Pyorala K, Laakso M. NIDDM and its metabolic control predict coronary heart disease in elderly subjects. Diabetes 1994;43:960-967. [Abstract]
Nisoldipine and Myocardial Infarction
Osende J. I., Walker A. M., Molitch M. E., Gheorghiade M., Schrier R. W., Estacio R. O., Jeffers B. W.
Extract |
Full Text
N Engl J Med 1998;
339:126-127, Jul 9, 1998.
Correspondence
American Diabetes Association,
(2010). Standards of Medical Care in Diabetes--2010. Diabetes Care
33: S11-S61
[Full Text]
Klapholz, M.
(2009). {beta}-Blocker Use for the Stages of Heart Failure. Mayo Clin Proc.
84: 718-729
[Abstract][Full Text]
O'Hare, A. M., Kaufman, J. S., Covinsky, K. E., Landefeld, C. S., McFarland, L. V., Larson, E. B.
(2009). Current Guidelines for Using Angiotensin-Converting Enzyme Inhibitors and Angiotensin II-Receptor Antagonists in Chronic Kidney Disease: Is the Evidence Base Relevant to Older Adults?. ANN INTERN MED
150: 717-724
[Abstract][Full Text]
American Diabetes Association,
(2009). Standards of Medical Care in Diabetes--2009. Diabetes Care
32: S13-S61
[Full Text]
Kjeldsen, S. E., Aksnes, T. A., Fagard, R. H., Mancia, G.
(2009). CHAPTER 13 Hypertension. ESC Textbook of Cardiovascular Medicine
2: med-9780199566990-chapter-med-9780199566990-chapter
[Abstract][Full Text]
Turnbull, F., Woodward, M., Neal, B., Barzi, F., Ninomiya, T., Chalmers, J., Perkovic, V., Li, N., MacMahon, S., the Blood Pressure Lowering Treatment Trialists' C,
(2008). Do men and women respond differently to blood pressure-lowering treatment? Results of prospectively designed overviews of randomized trials. Eur Heart J
29: 2669-2680
[Abstract][Full Text]
Holman, R. R., Paul, S. K., Bethel, M. A., Neil, H. A. W., Matthews, D. R.
(2008). Long-Term Follow-up after Tight Control of Blood Pressure in Type 2 Diabetes. NEJM
359: 1565-1576
[Abstract][Full Text]
Romero, J. R., Morris, J., Pikula, A.
(2008). Review: Stroke prevention: modifying risk factors. Ther Adv Cardiovasc Dis
2: 287-303
[Abstract]
Yee, J.
(2008). Diabetic Kidney Disease: Chronic Kidney Disease and Diabetes. Diabetes Spectr.
21: 8-10
[Full Text]
American Diabetes Association,
(2008). Standards of Medical Care in Diabetes--2008. Diabetes Care
31: S12-S54
[Full Text]
Air, E. L., Kissela, B. M.
(2007). Diabetes, the Metabolic Syndrome, and Ischemic Stroke: Epidemiology and possible mechanisms. Diabetes Care
30: 3131-3140
[Full Text]
Authors/Task Force Members:, , Mancia, G., De Backer, G., Dominiczak, A., Cifkova, R., Fagard, R., Germano, G., Grassi, G., Heagerty, A. M., Kjeldsen, S. E., Laurent, S., Narkiewicz, K., Ruilope, L., Rynkiewicz, A., Schmieder, R. E., Struijker Boudier, H. A.J., Zanchetti, A., ESC Committee for Practice Guidelines (CPG):, , Vahanian, A., Camm, J., De Caterina, R., Dean, V., Dickstein, K., Filippatos, G., Funck-Brentano, C., Hellemans, I., Kristensen, S. D., McGregor, K., Sechtem, U., Silber, S., Tendera, M., Widimsky, P., Zamorano, J. L., ESH Scientific Council:, , Kjeldsen, S. E., Erdine, S., Narkiewicz, K., Kiowski, W., Agabiti-Rosei, E., Ambrosioni, E., Cifkova, R., Dominiczak, A., Fagard, R., Heagerty, A. M., Laurent, S., Lindholm, L. H., Mancia, G., Manolis, A., Nilsson, P. M., Redon, J., Schmieder, R. E., Struijker-Boudier, H. A.J., Viigimaa, M., Document Reviewers:, , Filippatos, G., Adamopoulos, S., Agabiti-Rosei, E., Ambrosioni, E., Bertomeu, V., Clement, D., Erdine, S., Farsang, C., Gaita, D., Kiowski, W., Lip, G., Mallion, J.-M., Manolis, A. J., Nilsson, P. M., O'Brien, E., Ponikowski, P., Redon, J., Ruschitzka, F., Tamargo, J., van Zwieten, P., Viigimaa, M., Waeber, B., Williams, B., Zamorano, J. L.
(2007). 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J
0: ehm236v1-75
[Full Text]
Authors/Task Force Members, , Ryden, L., Standl, E., Bartnik, M., Berghe, G. V. d., Betteridge, J., de Boer, M.-J., Cosentino, F., Jonsson, B., Laakso, M., Malmberg, K., Priori, S., Ostergren, J., Tuomilehto, J., Thrainsdottir, I., Other Contributors, , Vanhorebeek, I., Stramba-Badiale, M., Lindgren, P., Qiao, Q., ESC Committee for Practice Guidelines (CPG), , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, J., Dean, V., Deckers, J., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J., Zamorano, J. L., Document Reviewers, , Deckers, J. W., Bertrand, M., Charbonnel, B., Erdmann, E., Ferrannini, E., Flyvbjerg, A., Gohlke, H., Juanatey, J. R. G., Graham, I., Monteiro, P. F., Parhofer, K., Pyorala, K., Raz, I., Schernthaner, G., Volpe, M., Wood, D.
(2007). Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: full text: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J Suppl
9: C3-C74
[Full Text]
Authors/Task Force Members, , Ryden, L., Standl, E., Bartnik, M., Van den Berghe, G., Betteridge, J., de Boer, M.-J., Cosentino, F., Jonsson, B., Laakso, M., Malmberg, K., Priori, S., Ostergren, J., Tuomilehto, J., Thrainsdottir, I., Other Contributors, , Vanhorebeek, I., Stramba-Badiale, M., Lindgren, P., Qiao, Q., ESC Committee for Practice Guidelines (CPG), , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, J., Dean, V., Deckers, J., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J., Zamorano, J. L., Document Reviewers, , Deckers, J. W., Bertrand, M., Charbonnel, B., Erdmann, E., Ferrannini, E., Flyvbjerg, A., Gohlke, H., Juanatey, J. R. G., Graham, I., Monteiro, P. F., Parhofer, K., Pyorala, K., Raz, I., Schernthaner, G., Volpe, M., Wood, D.
(2007). Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J
28: 88-136
[Full Text]
American Diabetes Association,
(2007). Standards of Medical Care in Diabetes--2007. Diabetes Care
30: S4-S41
[Full Text]
Nobakhthaghighi, N., Kamgar, M., Bekheirnia, M. R., McFann, K., Estacio, R., Schrier, R. W.
(2006). Relationship between Urinary Albumin Excretion and Left Ventricular Mass with Mortality in Patients with Type 2 Diabetes. CJASN
1: 1187-1190
[Abstract][Full Text]
Williams, B.
(2006). The Year in Hypertension. J Am Coll Cardiol
48: 1698-1711
[Full Text]
Ho, P. M., Rumsfeld, J. S., Masoudi, F. A., McClure, D. L., Plomondon, M. E., Steiner, J. F., Magid, D. J.
(2006). Effect of medication nonadherence on hospitalization and mortality among patients with diabetes mellitus.. Arch Intern Med
166: 1836-1841
[Abstract][Full Text]
Sever, P. S., Poulter, N. R., Elliott, W. J., Jonsson, M. C., Black, H. R., Sever, P. S., Poulter, N. R., Elliott, W. J., Jonsson, M. C., Black, H. R.
(2006). Blood Pressure Reduction Is Not the Only Determinant of Outcome. Circulation
113: 2754-2774
[Full Text]
Sacco, R. L., Adams, R., Albers, G., Alberts, M. J., Benavente, O., Furie, K., Goldstein, L. B., Gorelick, P., Halperin, J., Harbaugh, R., Johnston, S. C., Katzan, I., Kelly-Hayes, M., Kenton, E. J., Marks, M., Schwamm, L. H., Tomsick, T.
(2006). Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Council on Stroke: Co-Sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline.. Circulation
113: e409-e449
[Abstract][Full Text]
Marso, S. P., Hiatt, W. R.
(2006). Peripheral Arterial Disease in Patients With Diabetes. J Am Coll Cardiol
47: 921-929
[Abstract][Full Text]
Sacco, R. L., Adams, R., Albers, G., Alberts, M. J., Benavente, O., Furie, K., Goldstein, L. B., Gorelick, P., Halperin, J., Harbaugh, R., Johnston, S. C., Katzan, I., Kelly-Hayes, M., Kenton, E. J., Marks, M., Schwamm, L. H., Tomsick, T.
(2006). Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Council on Stroke: Co-Sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline.. Stroke
37: 577-617
[Abstract][Full Text]
American Diabetes Association,
(2006). Standards of Medical Care in Diabetes-2006. Diabetes Care
29: S4-S42
[Full Text]
Wilson, C., Gilliland, S., Cullen, T., Moore, K., Roubideaux, Y., Valdez, L., Vanderwagen, W., Acton, K.
(2005). Diabetes Outcomes in the Indian Health System During the Era of the Special Diabetes Program for Indians and the Government Performance and Results Act. AJPH
95: 1518-1522
[Abstract][Full Text]
Perreault, S., Lamarre, D., Blais, L., Dragomir, A., Berbiche, D., Lalonde, L., Laurier, C., St-Maurice, F., Collin, J.
(2005). Persistence with Treatment in Newly Treated Middle-Aged Patients with Essential Hypertension. The Annals of Pharmacotherapy
39: 1401-1408
[Abstract][Full Text]
Whelton, P. K., Barzilay, J., Cushman, W. C., Davis, B. R., IIamathi, E., Kostis, J. B., Leenen, F. H. H., Louis, G. T., Margolis, K. L., Mathis, D. E., Moloo, J., Nwachuku, C., Panebianco, D., Parish, D. C., Pressel, S., Simmons, D. L., Thadani, U., for the ALLHAT Collaborative Research Group,
(2005). Clinical Outcomes in Antihypertensive Treatment of Type 2 Diabetes, Impaired Fasting Glucose Concentration, and Normoglycemia: Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Arch Intern Med
165: 1401-1409
[Abstract][Full Text]
Blood Pressure Lowering Treatment Trialists' Colla,
(2005). Effects of Different Blood Pressure-Lowering Regimens on Major Cardiovascular Events in Individuals With and Without Diabetes Mellitus: Results of Prospectively Designed Overviews of Randomized Trials. Arch Intern Med
165: 1410-1419
[Abstract][Full Text]
(2005). Hypertension in type 2 diabetes - targeting angiotensin. DTB
43: 41-45
[Abstract][Full Text]
Pisu, M., James, N., Sampsel, S., Saag, K. G.
(2005). The cost of glucocorticoid-associated adverse events in rheumatoid arthritis. Rheumatology (Oxford)
44: 781-788
[Abstract][Full Text]
Williams, B.
(2005). Recent hypertension trials: Implications and controversies. J Am Coll Cardiol
45: 813-827
[Abstract][Full Text]
Epstein, B. J, Gums, J. G
(2005). Angiotensin Receptor Blockers versus ACE Inhibitors: Prevention of Death and Myocardial Infarction in High-Risk Populations. The Annals of Pharmacotherapy
39: 470-480
[Abstract][Full Text]
American Diabetes Association,
(2005). Standards of Medical Care in Diabetes. Diabetes Care
28: S4-S36
[Full Text]
Bakris, G. L., Gaxiola, E., Messerli, F. H., Mancia, G., Erdine, S., Cooper-DeHoff, R., Pepine, C. J., for the INVEST Investigators,
(2004). Clinical Outcomes in the Diabetes Cohort of the International Verapamil SR-Trandolapril Study. Hypertension
44: 637-642
[Abstract][Full Text]
Task Force Members, , Lopez-Sendon, J., Swedberg, K., McMurray, J., Tamargo, J., Maggioni, A. P., Dargie, H., Tendera, M., Waagstein, F., Kjekshus, J., Lechat, P., Pedersen, C. T.
(2004). Expert consensus document on angiotensin converting enzyme inhibitors in cardiovascular disease: The Task Force on ACE-inhibitors of the European Society of Cardiology. Eur Heart J
25: 1454-1470
[Full Text]
Parikh, C. R., Fischer, M. J., Estacio, R., Schrier, R. W.
(2004). Rapid microalbuminuria screening in type 2 diabetes mellitus: simplified approach with Micral test strips and specific gravity. Nephrol Dial Transplant
19: 1881-1885
[Abstract][Full Text]
Field, K. M., Pepin, J. L., Mehta, M. D.
(2004). Knowing When to Play the Ace: The Use and Under Use of Ace Inhibitors in Primary Practice. Journal of Pharmacy Practice
17: 197-210
[Abstract]
Lewis, E. J., Lewis, J. B.
(2004). ACE Inhibitors versus Angiotensin Receptor Blockers in Diabetic Nephropathy: Is There a Winner?. J. Am. Soc. Nephrol.
15: 1358-1360
[Full Text]
Lawes, C. M.M., Bennett, D. A., Feigin, V. L., Rodgers, A.
(2004). Blood Pressure and Stroke: An Overview of Published Reviews. Stroke
35: 1024-1033
[Abstract][Full Text]
Lawes, C. M.M., Bennett, D. A., Feigin, V. L., Rodgers, A.
(2004). Blood Pressure and Stroke: An Overview of Published Reviews. Stroke
35: 776-785
[Abstract][Full Text]
Durst, S. W., Schering, D.
(2004). Hypertension Management in the Diabetes Patient. Journal of Pharmacy Practice
17: 55-60
[Abstract]
Shinozaki, K., Ayajiki, K., Nishio, Y., Sugaya, T., Kashiwagi, A., Okamura, T.
(2004). Evidence for a Causal Role of the Renin-Angiotensin System in Vascular Dysfunction Associated With Insulin Resistance. Hypertension
43: 255-262
[Abstract][Full Text]
Trenkwalder, P.
(2004). Antihypertensive treatment with calcium channel blockers: pharmacological pornography or useful intervention?. Nephrol Dial Transplant
19: 17-20
[Full Text]
(2004). Standards of Medical Care in Diabetes. Diabetes Care
27: s15-35
[Full Text]
Nosadini, R., Tonolo, G.
(2004). Relationship between Blood Glucose Control, Pathogenesis and Progression of Diabetic Nephropathy. J. Am. Soc. Nephrol.
15: S1-5
[Abstract][Full Text]
Berl, T.
(2004). Angiotensin-Converting Enzyme Inhibitors versus AT1 Receptor Antagonist in Cardiovascular and Renal Protection: The case for AT1 Receptor Antagonist. J. Am. Soc. Nephrol.
15: S71-76
[Abstract][Full Text]
Pepine, C. J., Handberg, E. M., Cooper-DeHoff, R. M., Marks, R. G., Kowey, P., Messerli, F. H., Mancia, G., Cangiano, J. L., Garcia-Barreto, D., Keltai, M., Erdine, S., Bristol, H. A., Kolb, H. R., Bakris, G. L., Cohen, J. D., Parmley, W. W.
(2003). A Calcium Antagonist vs a Non-Calcium Antagonist Hypertension Treatment Strategy for Patients With Coronary Artery Disease: The International Verapamil-Trandolapril Study (INVEST): A Randomized Controlled Trial. JAMA
290: 2805-2816
[Abstract][Full Text]
Chobanian, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., Izzo, J. L. Jr, Jones, D. W., Materson, B. J., Oparil, S., Wright, J. T. Jr, Roccella, E. J., the National High Blood Pressure Education Program,
(2003). Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension
42: 1206-1252
[Abstract][Full Text]
Sleight, P.
(2003). PPOGRESS beyond HOPE and LIFE: The ONTARGET trial programme. Eur Heart J Suppl
5: F40-F47
[Abstract]
Ross, S., Macleod, M.-J.
(2003). Review: Hypertension in diabetes: a perspective from clinical pharmacology. British Journal of Diabetes & Vascular Disease
3: 252-256
[Abstract]
Goff, D. C. Jr.
(2003). The ALLHAT Study. Clin. Diabetes
21: 102-104
[Full Text]
Weber, M. A
(2003). Review: Angiotensin II receptor blockers and cardiovascular outcomes: what does the future hold?. Journal of Renin-Angiotensin-Aldosterone System
4: 62-73
[Abstract]
Ruilope, L. M, Segura, J., Schiffrin, E. L
(2003). Review: ACE inhibition or angiotensin receptor blockade: which should we use in diabetic patients?. Journal of Renin-Angiotensin-Aldosterone System
4: 74-79
[Abstract]
Psaty, B. M., Lumley, T., Furberg, C. D., Schellenbaum, G., Pahor, M., Alderman, M. H., Weiss, N. S.
(2003). Health Outcomes Associated With Various Antihypertensive Therapies Used as First-Line Agents: A Network Meta-analysis. JAMA
289: 2534-2544
[Abstract][Full Text]
Rosner, M. H., Okusa, M. D.
(2003). Combination Therapy With Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Antagonists in the Treatment of Patients With Type 2 Diabetes Mellitus. Arch Intern Med
163: 1025-1029
[Abstract][Full Text]
Wolf, G., Ritz, E.
(2003). Diabetic Nephropathy in Type 2 Diabetes Prevention and Patient Management. J. Am. Soc. Nephrol.
14: 1396-1405
[Full Text]
Mogensen, C. E., Viberti, G., Halimi, S., Ritz, E., Ruilope, L., Jermendy, G., Widimsky, J., Sareli, P., Taton, J., Rull, J., Erdogan, G., De Leeuw, P. W., Ribeiro, A., Sanchez, R., Mechmeche, R., Nolan, J., Sirotiakova, J., Hamani, A., Scheen, A., Hess, B., Luger, A., Thomas, S. M.
(2003). Effect of Low-Dose Perindopril/Indapamide on Albuminuria in Diabetes: Preterax in Albuminuria Regression: PREMIER. Hypertension
41: 1063-1071
[Abstract][Full Text]
Berl, T., Hunsicker, L. G., Lewis, J. B., Pfeffer, M. A., Porush, J. G., Rouleau, J.-L., Drury, P. L., Esmatjes, E., Hricik, D., Parikh, C. R., Raz, I., Vanhille, P., Wiegmann, T. B., Wolfe, B. M., Locatelli, F., Goldhaber, S. Z., Lewis, E. J., for the Collaborative Study Group*,
(2003). Cardiovascular Outcomes in the Irbesartan Diabetic Nephropathy Trial of Patients with Type 2 Diabetes and Overt Nephropathy. ANN INTERN MED
138: 542-549
[Abstract][Full Text]
Snow, V., Weiss, K. B., Mottur-Pilson, C., for the Clinical Efficacy Assessment Subcommittee,
(2003). The Evidence Base for Tight Blood Pressure Control in the Management of Type 2 Diabetes Mellitus. ANN INTERN MED
138: 587-592
[Abstract][Full Text]
Vijan, S., Hayward, R. A.
(2003). Treatment of Hypertension in Type 2 Diabetes Mellitus: Blood Pressure Goals, Choice of Agents, and Setting Priorities in Diabetes Care. ANN INTERN MED
138: 593-602
[Abstract][Full Text]
Douglas, J. G., Bakris, G. L., Epstein, M., Ferdinand, K. C., Ferrario, C., Flack, J. M., Jamerson, K. A., Jones, W. E., Haywood, J., Maxey, R., Ofili, E. O., Saunders, E., Schiffrin, E. L., Sica, D. A., Sowers, J. R., Vidt, D. G., the Hypertension in African Americans Working Grou,
(2003). Management of High Blood Pressure in African Americans: Consensus Statement of the Hypertension in African Americans Working Group of the International Society on Hypertension in Blacks. Arch Intern Med
163: 525-541
[Full Text]
Saseen, J. J., MacLaughlin, E. J., Westfall, J. M.
(2003). Treatment of Uncomplicated Hypertension: Are ACE Inhibitors and Calcium Channel Blockers as Effective as Diuretics and {beta}-Blockers?. J Am Board Fam Med
16: 156-164
[Full Text]
Mancia, G., Brown, M., Castaigne, A., de Leeuw, P., Palmer, C. R., Rosenthal, T., Wagener, G., Ruilope, L. M.
(2003). Outcomes With Nifedipine GITS or Co-Amilozide in Hypertensive Diabetics and Nondiabetics in Intervention as a Goal in Hypertension (INSIGHT). Hypertension
41: 431-436
[Abstract][Full Text]
August, P.
(2003). Initial Treatment of Hypertension. NEJM
348: 610-617
[Full Text]
Mehler, P. S., Coll, J. R., Estacio, R., Esler, A., Schrier, R. W., Hiatt, W. R.
(2003). Intensive Blood Pressure Control Reduces the Risk of Cardiovascular Events in Patients With Peripheral Arterial Disease and Type 2 Diabetes. Circulation
107: 753-756
[Abstract][Full Text]
Harris, R., Donahue, K., Rathore, S. S., Frame, P., Woolf, S. H., Lohr, K. N.
(2003). Screening Adults for Type 2 Diabetes: A Review of the Evidence for the U.S. Preventive Services Task Force. ANN INTERN MED
138: 215-229
[Abstract][Full Text]
Mooradian, A. D.
(2003). Cardiovascular Disease in Type 2 Diabetes Mellitus: Current Management Guidelines. Arch Intern Med
163: 33-40
[Abstract][Full Text]
Campos, A. H., Zhao, Y., Pollman, M. J., Gibbons, G. H.
(2003). DNA Microarray Profiling to Identify Angiotensin-Responsive Genes in Vascular Smooth Muscle Cells: Potential Mediators of Vascular Disease. Circ. Res.
92: 111-118
[Abstract][Full Text]
Williams, I. L, Vazir, A., Zaman, A. G
(2003). Review: The management of stable angina in diabetes. British Journal of Diabetes & Vascular Disease
3: 18-25
[Abstract]
Fisher, M.
(2003). Prevention of macrovascular complications. Eur Heart J Suppl
5: B21-B26
[Abstract]
(2003). Standards of Medical Care for Patients With Diabetes Mellitus. Diabetes Care
26: S33-S50
[Full Text]
Brown, N. J., Kumar, S., Painter, C. A., Vaughan, D. E.
(2002). ACE Inhibition Versus Angiotensin Type 1 Receptor Antagonism: Differential Effects on PAI-1 Over Time. Hypertension
40: 859-865
[Abstract][Full Text]
Campbell, R. C., Ruggenenti, P., Remuzzi, G.
(2002). Halting the Progression of Chronic Nephropathy. J. Am. Soc. Nephrol.
13: S190-195
[Abstract][Full Text]
Nosadini, R., Tonolo, G.
(2002). Cardiovascular and Renal Protection in Type 2 Diabetes Mellitus: The Role of Calcium Channel Blockers. J. Am. Soc. Nephrol.
13: S216-223
[Abstract][Full Text]
Sharp, A., Mayet, J.
(2002). Regression of left ventricular hypertrophy: hoping for a longer life. Journal of Renin-Angiotensin-Aldosterone System
3: 141-144
[Abstract]
Marso, S. P.
(2002). Optimizing the diabetic formulary: beyond aspirin and insulin. J Am Coll Cardiol
40: 652-661
[Abstract][Full Text]
Sica, D. A
(2002). Review: Rationale for combination therapy in the treatment of hypertension. Journal of Renin-Angiotensin-Aldosterone System
3: 63-65
[Abstract]
Motwani, J. G
(2002). Review: Combining renin-angiotensin-aldosterone system blockade with diuretic therapy for treatment of hypertension. Journal of Renin-Angiotensin-Aldosterone System
3: 72-78
[Abstract]
Swales, P., Williams, B.
(2002). Review: Calcium channel blockade in combination with angiotensin-converting enzyme inhibition or angiotensin II (AT1-receptor) antagonism in hypertensive diabetics and patients with renal disease and hypertension. Journal of Renin-Angiotensin-Aldosterone System
3: 79-89
[Abstract]
Garg, J., Messerli, A. W., Bakris, G. L.
(2002). Evaluation and Treatment of Patients With Systemic Hypertension. Circulation
105: 2458-2461
[Full Text]
Bonow, R. O., Mitch, W. E., Nesto, R. W., O'Gara, P. T., Becker, R. C., Clark, L. T., Hunt, S., Jialal, I., Lipshultz, S. E., Loh, E.
(2002). Prevention Conference VI: Diabetes and Cardiovascular Disease: Writing Group V: Management of Cardiovascular-Renal Complications. Circulation
105
: e159-e164
[Full Text]
Taler, S. J., Textor, S. C., Augustine, J. E.
(2002). Resistant Hypertension: Comparing Hemodynamic Management to Specialist Care. Hypertension
39: 982-988
[Abstract][Full Text]
Ghali, W. A., Cornuz, J., McAlister, F. A., Wasserfallen, J.-B., Devereaux, P.J., Naylor, C. D.
(2002). Accelerated publication versus usual publication in 2 leading medical journals. CMAJ
166: 1137-1143
[Abstract][Full Text]
Hilgers, K. F., Mann, J. F. E.
(2002). ACE Inhibitors versus AT1 Receptor Antagonists in Patients with Chronic Renal Disease. J. Am. Soc. Nephrol.
13: 1100-1108
[Full Text]
Hiatt, W.
(2002). Risk factor modification in intermittent claudication: effect on life expectancy and walking capacity. Eur Heart J Suppl
4: B50-B54
[Abstract]
Opie, L. H., Schall, R.
(2002). Evidence-based evaluation of calcium channel blockers for hypertension: Equality of mortality and cardiovascular risk relative to conventional therapy. J Am Coll Cardiol
39: 315-322
[Abstract][Full Text]
Sharma, M.
(2002). The RENAAL Study Investigation. Clin. Diabetes
20: 19-20
[Full Text]
Arauz-Pacheco, C., Parrott, M. A., Raskin, P.
(2002). The Treatment of Hypertension in Adult Patients With Diabetes. Diabetes Care
25: 134-147
[Full Text]
(2002). Standards of Medical Care for Patients With Diabetes Mellitus. Diabetes Care
25: 213-229
[Full Text]
Kaplan, N. M.
(2001). Management of Hypertension in Patients with Type 2 Diabetes Mellitus: Guidelines Based on Current Evidence. ANN INTERN MED
135: 1079-1083
[Abstract][Full Text]
Bakris, G. L.
(2001). A Practical Approach to Achieving Recommended Blood Pressure Goals in Diabetic Patients. Arch Intern Med
161: 2661-2667
[Abstract][Full Text]
Niskanen, L., Hedner, T., Hansson, L., Lanke, J., Niklason, A.
(2001). Reduced Cardiovascular Morbidity and Mortality in Hypertensive Diabetic Patients on First-Line Therapy With an ACE Inhibitor Compared With a Diuretic/{beta}-Blocker-Based Treatment Regimen: A subanalysis of the Captopril Prevention Project. Diabetes Care
24: 2091-2096
[Abstract][Full Text]
Brenner, B. M., Cooper, M. E., de Zeeuw, D., Keane, W. F., Mitch, W. E., Parving, H.-H., Remuzzi, G., Snapinn, S. M., Zhang, Z., Shahinfar, S., the RENAAL Study Investigators,
(2001). Effects of Losartan on Renal and Cardiovascular Outcomes in Patients with Type 2 Diabetes and Nephropathy. NEJM
345: 861-869
[Abstract][Full Text]
Swift, P. A, MacGregor, G. A
(2001). Renoprotection in Type 2 diabetes: blockade of the renin-angiotensin system with angiotensin II receptor blockers. Journal of Renin-Angiotensin-Aldosterone System
2: 170-173
A correction has been published: N Engl J Med 1998;339(18):1339.
Previous
