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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 (ClinicalTrials.gov 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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