[Syst-Eur study: analysis of the benefits of nitrendipine in hypertensive type 2 diabetics]

To demonstrate that nitrendipine reduces the morbimortality of elderly type 2 diabetic patients with isolated systolic hypertension.

New analyses of the 547 type 2 diabetics patients with isolated systolic hypertension (160 < PAS < 219: PAD < 95 mmHg), included in the international Syst-Eur trial, with an average follow-up of 2 years. Type 2 diabetes is defined according to the 1998 WHO guidelines: a fasting glycemia level, > or = 126 mg/dl and a post-prandial glycemia > or = 200 mg/dl.

Nitrendipine as a first line treatment provides better protection against fatal and no fatal cardiovascular events compared with placebo. The risk reduction of cardiovascular mortality is 70% (IC 95%: -89/-18; p = 0.01), 61% (IC 95%: -79/-29; p = 0.001) for fatal and non fatal cardiovascular events, 65% (IC 95%: -86/-10; p = 0.02) for fatal and non fatal stroke and 61% (IC 95%: -83/-11; p = 0.02) for fatal and non fatal cardiac events. Therefore, nitrendipine as a first line treatment, reduces significantly cardiovascular events, strokes and cardiac events (p = 0.02; p = 0.007; p = 0.009; p = 0.04, respectively) in the diabetic group versus the no diabetic group, with a big trend (p = 0.07) for total mortality. Nitrendipine was well tolerated by this population.

These results demonstrate the benefits of nitrendipine as a first line treatment in type 2 diabetic hypertensive patients.