Calcium channel blocker monotherapy versus combination with renin-angiotensin system inhibitors on the development of new-onset diabetes mellitus in hypertensive Korean patients

Yong Hoon Kim, Ae Young Her, Seung-Woon Rha, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Yoonjee Park, Dong Oh Kang, Won Young Jang, Woohyeun Kim, Woong Gil Choi, Tae Soo Kang, Jihun Ahn, Sang Ho Park, Ji Young Park, Min Ho Lee, Cheol Ung Choi, Chang Gyu Park, Hong Seog Seo

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2 Citations (Scopus)

Abstract

Background In real practice, two or more antihypertensive drugs are needed to achieve target blood pressure. We investigated the comparative beneficial actions of combination therapy of renin-angiotensin system inhibitors (RASI), with calcium channel blockers (CCB) over CCB monotherapy on the development of new-onset diabetes mellitus (NODM) in Korean patients during four-year follow-up periods. Methods A total of 3208 consecutive hypertensive patients without a history of diabetes mellitus who had been prescribed CCB were retrospectively enrolled from January 2004 to December 2012. These patients were divided into the two groups according to the additional use of RASI (the RASI group, n = 1221 and the no RASI group, n = 1987). Primary endpoint was NODM, defined as a fasting blood glucose ≥ 126 mg/dL or hemoglobin A1c ≥ 6.5%. Secondary endpoint was major adverse cardiac events (MACE) defined as total death, myocardial infarction (MI) and percutaneous coronary intervention (PCI). Results After propensity score-matched (PSM) analysis, two propensity-matched groups (939 pairs, n = 1878, C-statistic = 0.743) were generated. The incidences of NODM (HR = 1.009, 95% CI: 0.700-1.452, P = 0.962), MACE (HR = 0.877, 95% CI: 0.544-1.413, P = 0.589), total death, MI, PCI were similar between the two groups after PSM during four years. Conclusions The use of RASI in addition to CCB showed comparable incidences of NODM and MACE compared to CCB monotherapy in non-diabetic hypertensive Korean patients during four-year follow-up period. However, large-scaled randomized controlled clinical trials will be required for a more definitive conclusion.

Original languageEnglish
Pages (from-to)439-447
Number of pages9
JournalJournal of Geriatric Cardiology
Volume16
Issue number6
DOIs
Publication statusPublished - 2019 Jan 1

Keywords

  • Calcium channel blocker
  • Diabetes mellitus
  • Renin-angiotensin system inhibitors

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Cardiology and Cardiovascular Medicine

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    Kim, Y. H., Her, A. Y., Rha, S-W., Choi, B. G., Choi, S. Y., Byun, J. K., Park, Y., Kang, D. O., Jang, W. Y., Kim, W., Choi, W. G., Kang, T. S., Ahn, J., Park, S. H., Park, J. Y., Lee, M. H., Choi, C. U., Park, C. G., & Seo, H. S. (2019). Calcium channel blocker monotherapy versus combination with renin-angiotensin system inhibitors on the development of new-onset diabetes mellitus in hypertensive Korean patients. Journal of Geriatric Cardiology, 16(6), 439-447. https://doi.org/10.11909/j.issn.1671-5411.2019.06.003