Imperial College London
Dr Ajay K Gupta

Dr Ajay K Gupta

Faculty of Medicine, National Heart & Lung Institute

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 7594 3437a.k.gupta Website

 
 
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Location

 

ICCH59/61 North Wharf RoadSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@inproceedings{Gupta:2008:10.2337/dc07-1768,
author = {Gupta, AK and Dahlof, B and Dobson, J and Sever, PS and Wedel, H and Poulter, NR},
doi = {10.2337/dc07-1768},
pages = {982--988},
title = {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},
url = {http://dx.doi.org/10.2337/dc07-1768},
year = {2008}
}
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RIS format (EndNote, RefMan)

TY  - CPAPER
AB  - 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.
AU  - Gupta,AK
AU  - Dahlof,B
AU  - Dobson,J
AU  - Sever,PS
AU  - Wedel,H
AU  - Poulter,NR
DO  - 10.2337/dc07-1768
EP  - 988
PY  - 2008///
SN  - 0149-5992
SP  - 982
TI  - 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
UR  - http://dx.doi.org/10.2337/dc07-1768
ER  -
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