[Large clinical trials of ARB in Japan and its reflection to new guidelines].

Recently we are seeing reports of large scale clinical trials of ARB conducted in Japan. In CASE-J, candesartan (ARB) and amlodipine (Ca antagonist) show similar preventive effects on cardiovascular events in high risk hypertensive patients, whereas ARB prevents new-onset diabetes more effectively than Ca antagonist. In JIKEI HEART, the valsartan treatment group shows preventive effects on cardiovascular events compared with the non ARB treatment group in patients with hypertension, coronary heart disease and congestive heart failure. In INNOVATION and SMART telmisartan and valsartan indicate renoprotective effects in type 2 diabetic patients. We are now endeavoring to make the best use of the results from these trials in Japan as a source of evidence to support new guidelines (JSH2009).