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Randomised controlled trial
Valsartan is more effective than placebo in reducing the incidence of diabetes in people with impaired glucose tolerance and cardiovascular disease or risk factors but has no effect on cardiovascular outcomes
  1. Yves Lacourcière1,
  2. Luc Poirier1
  1. 1Hypertension Unit, Centre Hospitalier Universitaire de Québec, Quebec, Canada
  1. Correspondence to: Yves Lacourcière
    2705 Laurier Boulevard, Quebec, QC G1V 4G2, Canada; yves.lacourciere{at}

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Impaired glucose tolerance, which represents an intermediate stage before the onset of diabetes, is associated with an increased risk of cardiovascular diseases. Moreover, the concomitant presence of confirmed cardiovascular disease or cardiovascular risk factors in glucose-intolerant patients significantly augments their risk of cardiovascular events. Among the different treatment strategies used in high-risk patients, blockade of the renin-angiotensin system (RAS) has been shown to decrease the onset of new diabetes as well as the incidence of cardiovascular events. Therefore, the NAVIGATOR study was designed to evaluate the efficacy of blocking the RAS on the incidence of predetermined cardiovascular events such as myocardial infarction and stroke and on the prevalence of new diabetes.


This was a double-blind, randomised, placebo-controlled, clinical trial ( number, NCT00097786). Allocation was concealed, and patients, clinicians and the independent outcome adjudication committee were blinded. The study was set in 806 centres across 40 countries.

Participants included 9306 patients (mean age …

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