Valsartan Forestalled Diabetes But Not CV Events

Similar reductions have been noted with other inhibitors of the renin-angiotensin system, but these are far less impressive than those seen with successful life-style modifications or metformin, which reduced the onset of type II diabetes in similar patients in the Diabetes Prevention Program by 58% and 31%, respectively (N. Engl. J. Med. 2002;346:393-403).

It now appears that the goal of diabetes prevention is best addressed by changing behavior, and with the hope that improvements in cardiovascular (CV) outcomes will follow.

Until then, it seems reasonable to use an inhibitor of the RAS system as part of the antihypertensive regimen that most prediabetic and diabetic patients will need.

DR. BARRY MASSIE is professor of medicine at the University of California, San Francisco, and chief of cardiology at the San Francisco Veterans Affairs Medical Center. He has financial relationships with Novartis, Merck, and Cytokinetics, among other pharmaceutical companies.