STOP-NIDDM trial

The STOP-NIDDM trial followed 1429 patients with impaired glucose tolerance who were randomized to treatment with acarbose or placebo over 3 years. This trial demonstrated that normalization of glycemic control in subjects with impaired glucose tolerance significantly diminished cardiovascular risk. The acarbose-treated group had a significant reduction in the development of major cardiovascular events and hypertension. 

The STOP-NIDDM trial demonstrated that -glucosidase therapy in prediabetic persons successfully prevented a significant number of new cases of type 2 diabetes and helped restore beta-cell function, in addition to reducing cardiovascular disease and hypertension. Intervention with acarbose also reduced cardiovascular events in persons with diabetes. Diabetes and cardiovascular disease prevention may become a further indication for this class of medications. 

Chaisson JL et al Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance The STOP-NIDDM trial. JAMA 2003 290 486. 

In the STOP-NIDDM trial of acarbose cardiovascular risk and hypertension were reduced however, almost a quarter of the participants withdrew early, and the main cause of early withdrawal was gastrointestinal adverse effects (43). 

In the STOP-NIDDM trial the incidence of newly diagnosed hypertension was reduced by 34%. In a meta-analysis of controlled long-term studies with acarbose (MeRIA), systolic blood pressure was reduced by 2.7 mmHg (p = 0.024) [36]. The synergistic effect of AGls on blood pressure may be the result of improved endothelial function due to protection from vasotoxic postprandial glucose spikes [37]. 

Chiasson JL et al Acarbose for prevention of type 2 diabetes mellitus The STOP-NIDDM randomized trial. Lancet 2002 359 2072. [PMID 12086760]... 

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