{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:26:57Z","timestamp":1773286017138,"version":"3.50.1"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Thiazide-type diuretics are associated with an increased incidence of diabetes compared with other antihypertensive medications. In this study, we determined the long-term cardiovascular disease (CVD) consequences of incident diuretic-associated diabetes compared with the effects of incident diabetes associated with calcium channel blocker and angiotensin-converting enzyme inhibitor use.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              A total of 22 418 participants from the ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial) with baseline diabetes, incident diabetes (7.5% with chlorthalidone, 5.6% with amlodipine, and 4.3% with lisinopril), or no diabetes at 2 years of in-trial follow-up were followed for a mean total of 6.9 years (2.9 years in-trial and 4 additional years posttrial) through the use of national databases. The primary outcome was CVD mortality (death from coronary heart disease [CHD], stroke, heart failure, or other CVD). Among other outcomes were all-cause mortality, non-CVD mortality, and CHD (nonfatal myocardial infarction or fatal CHD). Participants on chlorthalidone with incident diabetes versus no diabetes had consistently lower, nonsignificant risk for CVD mortality (hazard ratio [HR], 1.04; 95% CI, 0.74\u20131.47), all-cause mortality (HR, 1.04; 95% CI, 0.82\u20131.30), and non-CVD mortality (HR, 1.05; 95% CI, 0.77\u20131.42) than participants on amlodipine or lisinopril with incident diabetes (HR range, 1.22\u20131.53). Participants with incident diabetes had elevated CHD risk compared with those with no diabetes (HR, 1.46; 95% CI, 1.09\u20131.96), but those on chlorthalidone had significantly lower risk than those on lisinopril (HR, 1.18 versus 2.57;\n              <jats:italic>P<\/jats:italic>\n              =0.04 for interaction).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>The findings suggest that thiazide-related incident diabetes has less adverse long-term CVD impact than incident diabetes that develops while on other antihypertensive medications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT00000542.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.111.962522","type":"journal-article","created":{"date-parts":[[2012,3,7]],"date-time":"2012-03-07T05:01:14Z","timestamp":1331096474000},"page":"153-162","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":64,"title":["Long-Term Effects of Incident Diabetes Mellitus on Cardiovascular Outcomes in People Treated for Hypertension"],"prefix":"10.1161","volume":"5","author":[{"given":"Joshua I.","family":"Barzilay","sequence":"first","affiliation":[{"name":"From the Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA (J.I.B.); The University of Texas School of Public Health, Houston, TX (S.L.P., B.R.D., C.E.F., L.B.P.); The National Heart, Lung, and Blood Institute, Bethesda, MD (J.A.C., P.T.E.); New York University Langone Medical Center, New York, NY (H.R.B.); Memphis Veterans Affairs Medical Center, Memphis, TN (W.C.C.); HealthPartners Research Foundation, Minneapolis, MN (K.L.M.); University of Colorado School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barry R.","family":"Davis","sequence":"additional","affiliation":[{"name":"From the Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA (J.I.B.); The University of Texas School of Public Health, Houston, TX (S.L.P., B.R.D., C.E.F., L.B.P.); The National Heart, Lung, and Blood Institute, Bethesda, MD (J.A.C., P.T.E.); New York University Langone Medical Center, New York, NY (H.R.B.); Memphis Veterans Affairs Medical Center, Memphis, TN (W.C.C.); HealthPartners Research Foundation, Minneapolis, MN (K.L.M.); University of Colorado School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara L.","family":"Pressel","sequence":"additional","affiliation":[{"name":"From the Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA (J.I.B.); The University of Texas School of Public Health, Houston, TX (S.L.P., B.R.D., C.E.F., L.B.P.); The National Heart, Lung, and Blood Institute, Bethesda, MD (J.A.C., P.T.E.); New York University Langone Medical Center, New York, NY (H.R.B.); Memphis Veterans Affairs Medical Center, Memphis, TN (W.C.C.); HealthPartners Research Foundation, Minneapolis, MN (K.L.M.); University of Colorado School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey A.","family":"Cutler","sequence":"additional","affiliation":[{"name":"From the Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA (J.I.B.); The University of Texas School of Public Health, Houston, TX (S.L.P., B.R.D., C.E.F., L.B.P.); The National Heart, Lung, and Blood Institute, Bethesda, MD (J.A.C., P.T.E.); New York University Langone Medical Center, New York, NY (H.R.B.); Memphis Veterans Affairs Medical Center, Memphis, TN (W.C.C.); HealthPartners Research Foundation, Minneapolis, MN (K.L.M.); University of Colorado School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula T.","family":"Einhorn","sequence":"additional","affiliation":[{"name":"From the Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA (J.I.B.); The University of Texas School of Public Health, Houston, TX (S.L.P., B.R.D., C.E.F., L.B.P.); The National Heart, Lung, and Blood Institute, Bethesda, MD (J.A.C., P.T.E.); New York University Langone Medical Center, New York, NY (H.R.B.); Memphis Veterans Affairs Medical Center, Memphis, TN (W.C.C.); HealthPartners Research Foundation, Minneapolis, MN (K.L.M.); University of Colorado School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry R.","family":"Black","sequence":"additional","affiliation":[{"name":"From the Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA (J.I.B.); The University of Texas School of Public Health, Houston, TX (S.L.P., B.R.D., C.E.F., L.B.P.); The National Heart, Lung, and Blood Institute, Bethesda, MD (J.A.C., P.T.E.); New York University Langone Medical Center, New York, NY (H.R.B.); Memphis Veterans Affairs Medical Center, Memphis, TN (W.C.C.); HealthPartners Research Foundation, Minneapolis, MN (K.L.M.); University of Colorado School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William C.","family":"Cushman","sequence":"additional","affiliation":[{"name":"From the Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA (J.I.B.); The University of Texas School of Public Health, Houston, TX (S.L.P., B.R.D., C.E.F., L.B.P.); The National Heart, Lung, and Blood Institute, Bethesda, MD (J.A.C., P.T.E.); New York University Langone Medical Center, New York, NY (H.R.B.); Memphis Veterans Affairs Medical Center, Memphis, TN (W.C.C.); HealthPartners Research Foundation, Minneapolis, MN (K.L.M.); University of Colorado School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles E.","family":"Ford","sequence":"additional","affiliation":[{"name":"From the Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA (J.I.B.); The University of Texas School of Public Health, Houston, TX (S.L.P., B.R.D., C.E.F., L.B.P.); The National Heart, Lung, and Blood Institute, Bethesda, MD (J.A.C., P.T.E.); New York University Langone Medical Center, New York, NY (H.R.B.); Memphis Veterans Affairs Medical Center, Memphis, TN (W.C.C.); HealthPartners Research Foundation, Minneapolis, MN (K.L.M.); University of Colorado School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen L.","family":"Margolis","sequence":"additional","affiliation":[{"name":"From the Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA (J.I.B.); The University of Texas School of Public Health, Houston, TX (S.L.P., B.R.D., C.E.F., L.B.P.); The National Heart, Lung, and Blood Institute, Bethesda, MD (J.A.C., P.T.E.); New York University Langone Medical Center, New York, NY (H.R.B.); Memphis Veterans Affairs Medical Center, Memphis, TN (W.C.C.); HealthPartners Research Foundation, Minneapolis, MN (K.L.M.); University of Colorado School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamaluddin","family":"Moloo","sequence":"additional","affiliation":[{"name":"From the Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA (J.I.B.); The University of Texas School of Public Health, Houston, TX (S.L.P., B.R.D., C.E.F., L.B.P.); The National Heart, Lung, and Blood Institute, Bethesda, MD (J.A.C., P.T.E.); New York University Langone Medical Center, New York, NY (H.R.B.); Memphis Veterans Affairs Medical Center, Memphis, TN (W.C.C.); HealthPartners Research Foundation, Minneapolis, MN (K.L.M.); University of Colorado School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Oparil","sequence":"additional","affiliation":[{"name":"From the Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA (J.I.B.); The University of Texas School of Public Health, Houston, TX (S.L.P., B.R.D., C.E.F., L.B.P.); The National Heart, Lung, and Blood Institute, Bethesda, MD (J.A.C., P.T.E.); New York University Langone Medical Center, New York, NY (H.R.B.); Memphis Veterans Affairs Medical Center, Memphis, TN (W.C.C.); HealthPartners Research Foundation, Minneapolis, MN (K.L.M.); University of Colorado School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda B.","family":"Piller","sequence":"additional","affiliation":[{"name":"From the Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA (J.I.B.); The University of Texas School of Public Health, Houston, TX (S.L.P., B.R.D., C.E.F., L.B.P.); The National Heart, Lung, and Blood Institute, Bethesda, MD (J.A.C., P.T.E.); New York University Langone Medical Center, New York, NY (H.R.B.); Memphis Veterans Affairs Medical Center, Memphis, TN (W.C.C.); HealthPartners Research Foundation, Minneapolis, MN (K.L.M.); University of Colorado School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debra L.","family":"Simmons","sequence":"additional","affiliation":[{"name":"From the Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA (J.I.B.); The University of Texas School of Public Health, Houston, TX (S.L.P., B.R.D., C.E.F., L.B.P.); The National Heart, Lung, and Blood Institute, Bethesda, MD (J.A.C., P.T.E.); New York University Langone Medical Center, New York, NY (H.R.B.); Memphis Veterans Affairs Medical Center, Memphis, TN (W.C.C.); HealthPartners Research Foundation, Minneapolis, MN (K.L.M.); University of Colorado School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Ellen","family":"Sweeney","sequence":"additional","affiliation":[{"name":"From the Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA (J.I.B.); The University of Texas School of Public Health, Houston, TX (S.L.P., B.R.D., C.E.F., L.B.P.); The National Heart, Lung, and Blood Institute, Bethesda, MD (J.A.C., P.T.E.); New York University Langone Medical Center, New York, NY (H.R.B.); Memphis Veterans Affairs Medical Center, Memphis, TN (W.C.C.); HealthPartners Research Foundation, Minneapolis, MN (K.L.M.); University of Colorado School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul K.","family":"Whelton","sequence":"additional","affiliation":[{"name":"From the Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA (J.I.B.); The University of Texas School of Public Health, Houston, TX (S.L.P., B.R.D., C.E.F., L.B.P.); The National Heart, Lung, and Blood Institute, Bethesda, MD (J.A.C., P.T.E.); New York University Langone Medical Center, New York, NY (H.R.B.); Memphis Veterans Affairs Medical Center, Memphis, TN (W.C.C.); HealthPartners Research Foundation, Minneapolis, MN (K.L.M.); University of Colorado School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan D.","family":"Wong","sequence":"additional","affiliation":[{"name":"From the Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA (J.I.B.); The University of Texas School of Public Health, Houston, TX (S.L.P., B.R.D., C.E.F., L.B.P.); The National Heart, Lung, and Blood Institute, Bethesda, MD (J.A.C., P.T.E.); New York University Langone Medical Center, New York, NY (H.R.B.); Memphis Veterans Affairs Medical Center, Memphis, TN (W.C.C.); HealthPartners Research Foundation, Minneapolis, MN (K.L.M.); University of Colorado School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Jackson T.","family":"Wright","sequence":"additional","affiliation":[{"name":"From the Kaiser Permanente of Georgia and Emory University School of Medicine, Atlanta, GA (J.I.B.); The University of Texas School of Public Health, Houston, TX (S.L.P., B.R.D., C.E.F., L.B.P.); The National Heart, Lung, and Blood Institute, Bethesda, MD (J.A.C., P.T.E.); New York University Langone Medical Center, New York, NY (H.R.B.); Memphis Veterans Affairs Medical Center, Memphis, TN (W.C.C.); HealthPartners Research Foundation, Minneapolis, MN (K.L.M.); University of Colorado School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the ALLHAT Collaborative Research Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.19.2534"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.19.2560"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.108.114389"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.23.2981"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/MNH.0b013e328057dea2"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000086521.95630.5A"},{"key":"e_1_3_3_8_2","unstructured":"World Health Organization. Two-Way Translator for the Ninth and Tenth Revisions. Geneva Switzerland: World Health Organization; 1997."},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(93)90031-8"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1991.03470010097038"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.20.2191"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.08.059"},{"key":"e_1_3_3_13_2","first-page":"257","article-title":"Diabetes mellitus in treated hypertension: incidence, predictive factors and the impact of non-selective beta-blockers and thiazide diuretics during 15 years treatment of middle-aged hypertensive men in the Primary Prevention Trial G\u00f6teborg, Sweden","volume":"8","author":"Samuelsson O","year":"1994","unstructured":"Samuelsson O, Hedner T, Berglund G, Persson B, Andersson OK, Wilhelmsen L. Diabetes mellitus in treated hypertension: incidence, predictive factors and the impact of non-selective beta-blockers and thiazide diuretics during 15 years treatment of middle-aged hypertensive men in the Primary Prevention Trial G\u00f6teborg, Sweden. J Hum Hypertens. 1994;8:257\u2013263.","journal-title":"J Hum Hypertens"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000231552.10054.aa"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.108.119438"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.hyp.0000231339.51310.b3"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.860"}],"container-title":["Circulation: Cardiovascular Quality and Outcomes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCOUTCOMES.111.962522","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T02:35:37Z","timestamp":1715567737000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCOUTCOMES.111.962522"}},"subtitle":["The ALLHAT Diabetes Extension Study"],"short-title":[],"issued":{"date-parts":[[2012,3]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2012,3]]}},"alternative-id":["10.1161\/CIRCOUTCOMES.111.962522"],"URL":"https:\/\/doi.org\/10.1161\/circoutcomes.111.962522","relation":{},"ISSN":["1941-7713","1941-7705"],"issn-type":[{"value":"1941-7713","type":"print"},{"value":"1941-7705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,3]]},"assertion":[{"value":"2011-06-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2011-12-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-03-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}