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Research Article
 
DOI:doi:10.11909/j.issn.1671-5411.2019.06.003
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.Calcium Channel Blocker monotherapy versus Combination with Renin-Angiotensin System Inhibitors on the Development of New-onset Diabetes Mellitus in Hypertensive Korean PatientsJ Geriatr Cardiol 2019,16(6):439~447
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Authors:Yong Hoon Kim1;Ae-Young Her1;Seung-Woon Rha2;Byoung Geol Choi3;Se Yeon Choi4;Jae Kyeong Byun4;Yoonjee Park5;Dong Oh Kang5;Won Young Jang5;Woohyeun Kim5;Woong Gil Choi6;Tae Soo Kang7;Jihun Ahn8;Sang-Ho Park9;Ji Young Park10;Min-Ho Lee11;Cheol Ung Choi12;Chang Gyu Park12;Hong Seog Seo12

Author Affiliation:1.Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea;2.Cardiovascular Center, Korea University Guro Hospital, Seoul, South Korea;Department of Medicine, Korea University Graduate School, Seoul, South Korea;3.Cardiovascular Center, Korea University Guro Hospital, Seoul, South Korea;4.Department of Medicine, Korea University Graduate School, Seoul, South Korea;5.Cardiovascular Center, Korea University Guro Hospital, Seoul, South Korea;6.Cardiology Department, Konkuk University Chungju Hospital, Chungju, South Korea;7.Department of Internal Medicine, Cardiovascular Division, Dankook University Hospital, Cheonan, South Korea;8.Department of Cardiology, Soonchunhyang University Gumi Hospital, Gumi, South Korea;9.Cardiology Department, Soonchunhyang University Cheonan Hospital, Cheonan, South Korea;10.Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Nowon Eulji Medical Center, Eulji University, Seoul, South Korea;11.Department of Cardiology, Soonchunhyang University College of Medicine, Seoul, South Korea;12.Cardiovascular Center, Korea University Guro Hospital, Seoul, South Korea;

Foundation:

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.

Keywords:

Calcium channel blocker; Diabetes mellitus; Renin-angiotensin system inhibitors
Received:March 28, 2019        Accepted:May 31, 2019   Published Online:June 28, 2019
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