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Gupta AK, Dahlof B, Dobson J, et al., 2008, Determinants of new-onset diabetes among 19,257 hypertensive patients randomized in the anglo-scandinavian cardiac outcomes trial-blood pressure lowering arm and the relative influence of antihypertensive medication, Pages: 982-988, ISSN: 0149-5992
OBJECTIVE - The purpose of this study was to determine the baseline predictors of new- onset diabetes (NOD) in hypertensive patients and to develop a risk score to identify those at high risk of NOD. RESEARCH DESIGN AND METHODS - Among 19,257 hypertensive patients in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA) who were randomly assigned to receive one of two antihypertensive regimens (atenolol ± thiazide or amlodipine ± perindopril), 14,120 were at risk of developing diabetes at baseline. Of these, 1,366 (9.7%) subsequently developed NOD during median follow-up of 5.5 years. A multivariate Cox model was developed to identify the independent predictors of NOD and individual risk scores. RESULTS - NOD was significantly associated with an increase in baseline fasting plasma glucose (FPG), BMI, serum triglycerides, and systolic blood pressure. In contrast, amlodipine ± perindopril in comparison with atenolol ± thiazide treatment (hazard ratio 0.66 [95% CI 0.59-0.74]), high HDL cholesterol, alcohol use, and age >55 years were found to be significantly protective factors. FPG was the most powerful predictor with risk increasing by 5.8 times (95% CI 5.23-6.43) for each millimole per liter rise >5 mmol/l. The risk of NOD increased steadily with increasing quartile of risk score, with a 19-fold increase (95% CI 14.3-25.4) among those in the highest compared with those in the lowest quartile. The model showed excellent internal validity and discriminative ability. CONCLUSIONS - Baseline FPG >5 mmol/l, BMI, and use of an atenolol ± diuretic regimen were among the major determinants of NOD in hypertensive patients. The model developed from these data allows accurate prediction of NOD among hypertensive subjects. © 2008 by the American Diabetes Association.
Gupta AK, Dahlof B, Dobson J, et al., 2008, Determinants of new-onset diabetes among 19,257 hypertensive patients randomized in the Anglo-Scandinavian Cardiac Outcomes Trial-blood pressure lowering arm and the relative influence of antihypertensive medication, DIABETES CARE, Vol: 31, Pages: 982-988, ISSN: 0149-5992
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- Citations: 124
Sever PS, Poulter NR, Dahlof B, et al., 2008, The Anglo-Scandinavian Cardiac Outcomes Trial lipid lowering arm:: extended observations 2 years after trial closure, EUROPEAN HEART JOURNAL, Vol: 29, Pages: 499-508, ISSN: 0195-668X
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- Citations: 71
Lindgren P, Buxton M, Kahan T, et al., 2008, Economic evaluation of ASCOT-BPLA:: antihypertensive treatment with an amlodipine-based regimen is cost effective compared with an atenolol-based regimen, HEART, Vol: 94, ISSN: 1355-6037
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- Citations: 16
Patel A, MacMahon S, Chalmers J, et al., 2008, Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes, New England Journal of Medicine, Vol: 358, Pages: 2560-2572
Tapp R, Sharp A, Stanton A, et al., 2007, Left ventricular diastolic function assessed by tissue Doppler echocardiography is impaired by β-blocker plus diuretic-based therapy compared with calcium, antagonist plus Ace inhibitor-based therapy:: An ASCOT substudy, 80th Annual Scientific Session of the American-Heart-Association, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: 609-609, ISSN: 0009-7322
Hughes A, Manisty C, Zambanini A, et al., 2007, Lower augmentation index and wave reflection in hypertensive subjects treated with atorvastatin; An ASCOT-LLA substudy, 80th Annual Scientific Session of the American-Heart-Association, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: 609-609, ISSN: 0009-7322
Gupta AK, Poulter NR, Dahlof B, et al., 2007, Role of metabolic syndrome, independent of its components, in prediction of cardiovascular outcomes in hypertensive patients in the ASCOT-BPLA, JOURNAL OF HUMAN HYPERTENSION, Vol: 21, Pages: 836-837, ISSN: 0950-9240
Patel A, MacMahon S, Chalmers J, et al., 2007, Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial, LANCET, Vol: 370, Pages: 829-840, ISSN: 0140-6736
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- Citations: 1573
Chapman N, Dobson J, Wilson S, et al., 2007, Spironolactone in resistant hypertension - Reply, HYPERTENSION, Vol: 50, Pages: E58-E58, ISSN: 0194-911X
Lindgren P, Buxton M, Kahan T, et al., 2007, Amlodipine plus atorvastatin is cost-effective compared to atenolol plus atorvastatin, amlodipine or atenolol alone: The Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT), EUROPEAN HEART JOURNAL, Vol: 28, Pages: 857-857, ISSN: 0195-668X
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- Citations: 2
Gupta AK, Poulter NR, 2007, Antihypertensive-associated incident diabetes: Controversy persists, ARCHIVES OF INTERNAL MEDICINE, Vol: 167, Pages: 1433-1433, ISSN: 0003-9926
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- Citations: 1
Gupta AK, Poulter N, 2007, Improving the prognosis in patients with diabetes: What will ADVANCE tell us?, AMERICAN JOURNAL OF HYPERTENSION, Vol: 20, Pages: 19S-22S, ISSN: 0895-7061
Poulter N, 2007, Improving prognosis in diabetic patients: What will advance tell us?, 17th European Meeting on Hypertension, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: S387-S387, ISSN: 0263-6352
Lindgren P, Buxton M, Kahan T, et al., 2007, An amlodipine-based regimen is cost-effective compared to an atenolol-based regimen:: Results from the Anglo-Scandinavian cardiac outcomes trial, 17th European Meeting on Hypertension, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: S137-S137, ISSN: 0263-6352
Koren M, Lindgren P, Buxton M, et al., 2007, Cost-effectiveness of multi-drug regimen of amlodipine plus atorvastatin based on the anglo-scandinavian cardiac outcomes trial (ASCOT):: An economic sub-analysis, 8th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E568-E568, ISSN: 0009-7322
Glasziou P, Alexander J, Beller E, et al., 2007, Which health-related quality of life score? A comparison of alternative utility measures in patients with Type 2 diabetes in the ADVANCE trial., Health and Quality of Life Outcomes, Vol: 5, ISSN: 1477-7525
BACKGROUND: Diabetes has a high burden of illness both in life years lost and in disability through related co-morbidities. Accurate assessment of the non-mortality burden requires appropriate health-related quality of life and summary utility measures of which there are several contenders. The study aimed to measure the impact of diabetes on various health-related quality of life domains, and compare several summary utility measures. METHODS: In the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation) study, 978 Australian patients with Type 2 diabetes completed two health-related quality of life questionnaires at baseline: the EQ-5D and the SF-36v2, from which nine summary utility measures were calculated, and compared. The algorithms were grouped into four classes: (i) based on the EQ-5D; (ii) using fewer items than those in the SF-12 (iii) using the items in the SF-12; and (iv) using all items of the SF-36. RESULTS: Overall health-related quality of life of the subjects was good (mean utility ranged from 0.68 (+/-0.08) to 0.85(+/-0.14) over the nine utility measures) and comparable to patients without diabetes. Summary indices were well correlated with each other (r = 0.76 to 0.99), and showed lower health-related quality of life in patients with major diabetes-related events such as stroke or myocardial infarction. Despite the smaller number of items used in the scoring of the EQ-5D, it generally performed at least as well as SF-36 based methods. However, all utility measures had some limitation such as limited range or ceiling effects. CONCLUSION: The summary utility measures showed good agreement, and showed good discrimination between major and minor health state changes. However, EQ-5D based measures performed as well and are generally simpler to use.
Chapman N, Dobson J, Wilson S, et al., 2007, Effect of spironolactone on blood pressure in subjects with resistant hypertension, HYPERTENSION, Vol: 49, Pages: 839-845, ISSN: 0194-911X
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- Citations: 460
Poulter NR, Chang C-L, Sever PS, et al., 2007, The impact of age on blood pressure reduction due to atenolol and amlodipine in the blood-pressure lowering arm of the anglo-scandinavian cardiac outcomes trial, 56th Annual Scientific Session of the American-College-of-Cardiology, Publisher: ELSEVIER SCIENCE INC, Pages: 371A-371A, ISSN: 0735-1097
Lindgren P, Tang S, Buxton M, et al., 2007, Economic evaluation of the anglo-Scandinavian cardiac outcomes trial (ASCOT)-blood pressure lowering arm (BPLA):: A sub-study on incremental cost-effectiveness of amlodipine-based regimen vs. atenolol-based regimen in primary prevention among hypertensive patients with additional risk factors, 56th Annual Scientific Session of the American-College-of-Cardiology, Publisher: ELSEVIER SCIENCE INC, Pages: 392A-392A, ISSN: 0735-1097
Gupta AK, Poulter NR, Dahlot B, et al., 2007, Role of metabolic syndrome, independent of its components, in prediction of cardiovascular outcomes in hypertensive patients of ASCOT- BPLA, 56th Annual Scientific Session of the American-College-of-Cardiology, Publisher: ELSEVIER SCIENCE INC, Pages: 417A-417A, ISSN: 0735-1097
Lindgren P, Kahan T, Poulter N, et al., 2007, Utility loss and indirect costs following cardiovascular events in hypertensive patients:: the ASCOT health economic substudy, EUROPEAN JOURNAL OF HEALTH ECONOMICS, Vol: 8, Pages: 25-30, ISSN: 1618-7598
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- Citations: 22
Sever P, Dahlof B, Poulter N, et al., 2007, Potential synergy between lipid-lowering and blood-pressure-lowering in the Anglo-Scandinavian Cardiac Outcomes Trial (vol 27, pg 2982, 2006), EUROPEAN HEART JOURNAL, Vol: 28, Pages: 142-142, ISSN: 0195-668X
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- Citations: 4
Wilson SL, Poulter NR, 2007, Effects of non-steroidal anti-inflammatory drugs on blood pressure - Reply, JOURNAL OF HYPERTENSION, Vol: 25, Pages: 248-249, ISSN: 0263-6352
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- Citations: 1
Poulter NR, 2006, Hypertension guidelines: An international comparison, 21st Scientific Meeting of the International-Society-of-Hypertension/5th Asian-Pacific Congress of Hypertension/29th Annual Scientific Meeting of the Japanese-Society-of-Hypertension, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: 17-17, ISSN: 0263-6352
Gupta AK, Poulter NR, Dahlof B, et al., 2006, Determinants of new onset diabetes among hypertensive patients randomised in the ASCOT-BPLA trial, 21sth Scientific Meeting of the International-Society-of-Hypertension/5th Asian-Pacific Congress of Hypertension/29th Annual Scientific Meeting of the Japanese-Society-of-Hypertension, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: 43-43, ISSN: 0263-6352
Poulter N, 2006, Are current therapies for hypertension achieving their goal?, JOURNAL OF THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM, Vol: 7, Pages: S3-S6, ISSN: 1470-3203
Chang CL, Poulter NR, Chapman N, et al., 2006, The effect on blood pressure and lipid profiles of doxazosin GITS as a third-line agent in the ASCOT-BPLA trial, 21sth Scientific Meeting of the International-Society-of-Hypertension/5th Asian-Pacific Congress of Hypertension/29th Annual Scientific Meeting of the Japanese-Society-of-Hypertension, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: 64-64, ISSN: 0263-6352
Sever P, Dahlof B, Poulter N, et al., 2006, Cardiovascular event reduction in the anglo-scandinavian cardiac outcomes trial (ASCOT): Combined benefits of blood pressure reduction, lipid-lowering and treatment with a "newer" compared with an "older" antihypertensive treatment regimen, 21sth Scientific Meeting of the International-Society-of-Hypertension/5th Asian-Pacific Congress of Hypertension/29th Annual Scientific Meeting of the Japanese-Society-of-Hypertension, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: 30-30, ISSN: 0263-6352
Poulter N, 2006, Decreasing coronary events: Recent trial evidence, 21sth Scientific Meeting of the International-Society-of-Hypertension/5th Asian-Pacific Congress of Hypertension/29th Annual Scientific Meeting of the Japanese-Society-of-Hypertension, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: 417-417, ISSN: 0263-6352
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