Candesartan prevented development of diabetes mellitus in heart failure.

M e t h o d s Design: Prespecified secondary analysis of 3 randomized, placebo-controlled trials (Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity Program [CHARM]). Allocation: {Concealed}†.* Blinding: Blinded {clinicians, patients, data collectors, outcome assessors, monitoring committee, manuscript writers, and data analysts}†.* Follow-up period: Median 3.1 years. Setting: {618 centers in 26 countries}†. Patients: 5436 patients (mean age 66 y, 69% men) with symptomatic heart failure who did not have diabetes at baseline came from 3 parallel trials (CHARM-Alternative: patients with left ventricular ejection fraction [LVEF] ≤ 40% who were intolerant of angiotensinconverting enzyme [ACE] inhibitors; CHARM-Added: patients with LVEF ≤ 40% and receiving an ACE inhibitor; and CHARM-Preserved: patients with LVEF > 40%). Intervention: Candesartan (incremental doses up to a maximum of 32 mg/d as tolerated) (n = 2715) or matching placebo (n = 2721). Outcomes: Development of diabetes and a composite endpoint of diabetes and all-cause mortality. Patient follow-up: 99.9% (intention-to-treat analysis).