Background: The KYOTO HEART Study demonstrated that Valsartan Add-on treatment was effective to reduce new-onset diabetes in high-risk hypertensive patients. The purpose of the present study was to examine the effects of Valsartan Add-on treatment on cardiovascular (CV) events in patients with or without diabetes.
Methods and results: A total of 3,031 patients were divided at baseline: Baseline Diabetes (n=807) and Baseline Non-Diabetes (n=2,224). Among the Non-Diabetes patients, 144 developed diabetes (New-Onset Diabetes) and the remaining patients did not throughout the study (Final Non-Diabetes, n=2,080). Baseline Diabetes showed significantly higher CV event rates than Baseline Non-Diabetes (10.3% vs. 7.0%, P=0.00400). Valsartan Add-on treatment significantly reduced CV event rates than Non-angiotensin receptor blocker (ARB) treatment both in Baseline Diabetes (6.7% vs. 13.8%, P=0.00274) and in Baseline Non-Diabetes (5.0% vs. 8.9%, P=0.00036), respectively. New-Onset Diabetes showed a similar CV event rate (12.5%) to Baseline Diabetes (10.3%) but the event rate was significantly higher than that of Final Non-Diabetes (6.6%, P=0.0065). In the New-Onset Diabetes, Valsartan add-on treatment significantly reduced CV event rate than Non-ARB treatment (5.2% vs. 17.4%, P=0.04601).
Conclusions: CV event risk in New-Onset Diabetes was relatively equivalent to Baseline Diabetes. Valsartan Add-on treatment was effective for the reduction of CV events not only in Baseline Diabetes but also in New-Onset Diabetes.