Aim: To investigate the relation between cardiovascular events and blood pressure or blood glucose control during long-term treatment with candesartan cilexetil in Japanese patients with hypertension and diabetes mellitus.
Methods: During a planned 3-year follow-up period, five surveys were performed (at registration, after 6 months, and after 1-3 years).
Results: Among 17,622 patients registered nationwide, 16,869 were available for safety evaluation and 16,860 for efficacy evaluation. The actual mean follow-up period was 29 months, and the annual incidence of primary cardiovascular events was 17.4/1000 persons. After 3 years, 18.0% of the patients had a blood pressure <130/80 mmHg, while 45.4% had a hemoglobin A(1c) <6.5%. Compared with these patients showing good control of hypertension and/or diabetes, the incidence of cardiovascular events was significantly higher in patients with poor control.
Conclusion: These findings emphasize the importance of tight blood pressure and glycemic control in hypertensive patients with diabetes. In addition, the target blood pressure (<130/80 mmHg) in the 2004 Japanese Hypertension Management Guidelines and the target hemoglobin A(1c) (<6.5%) in the Japanese Treatment Guide for Diabetes were supported. (C) 2008 Elsevier Ireland Ltd. All rights reserved.