Comparison between calcium channel blocker with angiotensin converting enzyme inhibitor or angiotensin II type 1 receptor blocker combination on the development of new-onset diabetes in hypertensive Korean patients

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

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Background and purpose: Rare comparative studies investigated the relationship between combination therapy of antihypertensive drugs and the incidence of new-onset diabetes mellitus (NODM). The aim of this study was to evaluate which combination therapy, calcium channel blocker (CCB) with angiotensin converting enzyme inhibitor (ACEI) or CCB with angiotensin II type 1 receptor blocker (ARB), is best in reducing/preventing the development of NODM during 4-year follow-up periods in non-diabetic hypertensive Korean patients. Materials and methods: Finally, a total of 1221 consecutive hypertensive patients without a history of diabetes mellitus who had been prescribed CCB were retrospectively enrolled and divided into the two groups, an ACEI group (combination CCB with ACEI, n = 251) and an ARB group (combination CCB with ARB, n = 970). The 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, non-fatal myocardial infarction (MI) and percutaneous coronary intervention (PCI). Results: After propensity-score matched (PSM) analysis, two propensity-matched groups (243 pairs, n = 486, C-statistic = 0.696) were generated. During 4-year follow-up periods, there were similar incidence of NODM (Hazard ratio [HR]; 1.198, 95% confidence interval [CI]; 0.591–2.431, P = 0.616), MACE (HR; 1.324, 95% CI; 0.714–2.453, P = 0.373), total death, MI and PCI between the two groups after PSM analysis. Conclusion: CCB with ACE or CCB with ARB combination strategies are equally acceptable in hypertensive Korean patients regarding the occurrence of NODM.

    Original languageEnglish
    Pages (from-to)405-413
    Number of pages9
    JournalJournal of Diabetes and Metabolic Disorders
    Volume19
    Issue number1
    DOIs
    Publication statusPublished - 2020 Jun 1

    Keywords

    • Angiotensin II type 1 receptor blocker
    • Angiotensin converting enzyme inhibitor
    • Calcium channel blocker
    • Diabetes mellitus

    ASJC Scopus subject areas

    • Internal Medicine
    • Endocrinology, Diabetes and Metabolism

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