Effects of antihypertensive treatment on endpoints in the diabetic patients randomized in the Systolic Hypertension in Europe (Syst-Eur) trial

In this review we attempt to determine the role of calcium channel blockers in preventing cardiovascular sequela in patients with both hypertension and diabetes mellitus. The data have been collected from three sources: post hoc analyses of subgroups of diabetic patients in placebo-controlled hypertension trials (SHEP, Syst-Eur, Syst-China); a stepped care blood pressure oriented trial (HOT); and comparative trials primarily focussing on metabolic aspects and intermediate endpoints (ABCD, FACET). On balance, the data seem to indicate that long-acting calcium channel blockers score remarkably well in preventing cardiovascular complications in diabetic hypertensive patients.