Primary Prevention of Cardiovascular Disease (CVD) in Pre-diabetic & Pre-hypertensive Subjects

Primary Prevention of Cardiovascular Disease in Pre-diabetic & Pre-hypertensive Subjects Using Multiple Risks Reduction Strategy: A Multi-center, Double-blind, Randomized Controlled Trial

The purpose of this study is to determine whether treating pre-diabetic & pre-hypertensive individuals using multiple drugs intervention (anti-hypertensive drugs (i.e., ACEI) plus anti-glycemic drug (i.e., metformin) plus anti-hyperlipidemic drug (statin)) would lower Cardiovascular Disease (CVD) events.

The risks of CVD are not confined to a subset of established "hypertensive" or "diabetic" population, but also increase among those with suboptimal blood pressure and glycemic level, namely "pre-hypertensive" or "pre-diabetic" population. Evidence on the effectiveness of drug interventions to lower CVD events in pre-clinical stage population has been scant.

Inclusion Criteria:

• Pre-diabetes
• Pre-hypertensives
• LDL-Cholesterol >= 100 < 190 mg/dl
• BMI >= 23
• Estimated GFR >= 60 ml/min/1.73 m2 (MDRD equation)
• Willing to participate and provide written inform consent

Exclusion Criteria:

• Current involved in other studied medications
• Regular use of corticosteroids
• Current use of weight loss medication
• History of renal disease
• Active liver disease including jaundice, chronic hepatitis with ALT >= 2.5 the upper normal limit
• Active malignancy
• Major psychiatric disorder
• Diseases and medications that affect glucose tolerance (e.g. pheochromocytoma, Cushing's syndrome, acromegaly, steroid-dependent asthma, protease inhibitors, antipsychotics)
• Nursing women, pregnant women, or those that plan to become pregnant in the study period