Comparison Between Valsartan and Amlodipine …：缬沙坦与氨氯地平的比较….pptx

Presenter disclosure information Toyoaki Murohara, MD, PhD. Lecturer ’ s fee from Daiichi-Sankyo, Novartis Pharma , Pfizer, and Takeda (Modest). ACC 2011, LBCT Funding / support information ? Funding / Support: The NAGOYA HEART Study was funded and supported by Nagoya University Graduate School of Medicine. ? Role of the Sponsor: The funding source had no role in the study design, data collection, analyses and interpretation, or in the preparation, review, or approval of the manuscript. ACC 2011, LBCT The NAGOYA Castle Golden Shachi-hoko = Symbol of Nagoya City NAGOYA City ACC 2011, LBCT Background ? Hypertensive patients are plicated with type 2 diabetes ( T2DM) and, combination of hypertension and T2DM markedly increases cardiovascular event risk. ? ACEIs / ARBs reduce the new onset of T2DM * and slowed-down the progression of diabetic nephropathy ?. * Yusuf S, et al. JAMA. 2001; 286: 1882-1885. * McMurray JJ, et al. N Engl J Med. 2010 ; 362: 1477-1490. ? HOPE Investigators. Lancet . 2000; 355: 253-259. ? Brenner BM, et al. N Engl J Med. 2001; 345: 861-869. ACC 2011, LBCT JNC7 2003 ADA 2004 ESC-ESH 2007 JSH 2009 ACEIs ◎◎◎◎ ARBs ◎◎◎◎ CCBs ○△○○β-blockers ○○○○α-blockers NA△△ NA Diuretics ○○○○◎ mended as a First-Choice Agent, ○ Available as an Alternative Agent, △ Not mended Many guidelines mend ACEIs / ARBs as the first-line antihypertensive medications for diabetic hypertensive patients. ACC 2011, LBCT Background Trials n DM Control CV es HRs (95% CIs) LIFE DM-subgroup (2001) 1195 100% posite CV death Acute MI Stroke (-) (-) (-) (-) IDNT CV es-analysis (2003) 1146 100% posite CV death Acute MI PCI/CABG Heart Failure Stroke (-) (-) (-) (-) (-) (-) VALUE (2004) 15245 34% posite CV death Acute MI Heart Failure (-) (-) (-) (-) CASE-J (2008) 4728 43% posite Sudden death Ac