Table 1.
Summary of clinical studies showing the effect of RAS inhibition on new‐onset type 2 diabetes mellitus
| Trial | Characteristics of participants | Comparison groups | No. participants in analysis† | Duration of follow up (years) | Relative risk (95% confidence interval) | Reference | |
|---|---|---|---|---|---|---|---|
| Treatment group | Control group | ||||||
| CAPPP | Aged 25–66 years with diastolic hypertension | Captopril | Diuretics, β‐blockers | 5,183 vs 5,230 | Mean 6.1 | 0.86 (0.74–0.99) | 26 |
| HOPE | Aged ≥55 years with coronary artery disease, stroke, peripheral vascular disease | Ramipril | Placebo | 2,837 vs 2,883 | Median 4.5 | 0.66 (0.51–0.85) | 27 |
| ALLHAT | Aged ≥55 years with hypertension and at least one other coronary heart disease risk factor | Lisinopril | Chlorthalidone | 2,567 vs 4,543 | Median 4.9 | 0.70 (0.63–0.77) | 28, 29 |
| Amlodipine | 2,567 vs 2,692 | 0.83 (0.74–0.93) | |||||
| LIFE | Aged 55–80 years with hypertension and left ventricular hypertrophy | Losartan | Atenolol | 4,019 vs 3,979 | Mean 4.8 | 0.75 (0.63–0.88) | 30 |
| SCOPE | Aged 70–89 years with hypertension | Candesartan | Placebo | 2,167 vs 2,175 | Mean 3.7 | 0.75 (NA), P = 0.09 | 31 |
| CHARM | Aged >18 years with heart failure NYHA grade II–IV | Candesartan | Placebo | 2,715 vs 2,721 | Median 3.1 | 0.78 (0.64–0.96) | 88 |
| PEACE | Aged ≥50 years with stable coronary artery disease and left ventricular ejection fraction >40% | Trandolapril | Placebo | 3,432 vs 3,472 | Median 4.8 | 0.83 (0.72–0.96) | 89 |
| VALUE | Aged ≥50 years with hypertension and high risk of cardiovascular events | Valsartan | Amlodipine | 5,032 vs 4,963 | Mean 4.2 | 0.77 (0.69–0.87) | 32 |
| DREAM‡ | Aged ≥30 years without cardiovascular disease but with impaired fasting glucose or impaired glucose tolerance | Ramipril | Placebo | 2,623 vs 2,646 | Median 3.0 | 0.91 (0.81–1.03) | 33 |
| ONTARGET | Aged ≥55 years with coronary, peripheral artery or cerebrovascular disease | Ramipril +Telmisartan | Ramipril | 5,280 vs 5,427 | Median 4.7 | 0.91 (0.78–1.06) | 90 |
| TRANSCEND | Aged ≥55 years with coronary, peripheral artery or cerebrovascular disease | Telmisartan | Placebo | 1,895 vs 1,913 | Median 4.7 | 0.85 (0.71–1.02) | 90 |
| NAVIGATOR‡ | Aged ≥50 years with impaired glucose tolerance and established cardiovascular disease or cardiovascular risk factors | Valsartan | Placebo | 4,631 vs 4,675 | Median 5.0 | 0.86 (0.80–0.92) | 34 |
| CASE‐J Ex | 20–Aged 85 years, Japanese with hypertension and at least one risk factor for cardiovascular events | Candesartan | Amlodipine | 636 vs 620 | Mean 4.5 | 0.71 (0.51–1.00) | 91 |
| ANBP2 | Aged 65–84 years with hypertension, but having no recent cardiovascular morbidity (within 6 months) | Enalapril | Hydrochlorothiazide | 2,815 vs 2,827 | Median 6.9 | 0.70 (0.56–0.86) | 92, 93 |
Number of participants included in the analysis of secondary outcomes was estimated as the number of total participants – the number of participants with type 2 diabetes mellitus at baseline, if there was no information in the original article.
Only Diabetes Reduction Approaches With Ramipril and Rosiglitazone Medications (DREAM) and Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) were the double‐blind, placebo‐controlled, randomized trials whose primary outcome was the development of type 2 diabetes mellitus. CAPPP, Captopril Prevention Project; HOPE, Heart Outcomes Prevention Evaluation; LIFE, Losartan Intervention For End Point Reduction in Hypertension; NA, not available; NYHA, New York Heart Association; SCOPE, Study on Cognition and Prognosis in the Elderly; VALUE, Valsartan Antihypertensive Long‐Term Use Evaluation.