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ACE Inhibitors Linked to Better CV Outcomes Than ARBs in Patients with Diabetes — Physician’s First Watch

Medical News |
April 1, 2014

ACE Inhibitors Linked to Better CV Outcomes Than ARBs in Patients with Diabetes

By Kelly Young

Angiotensin-converting-enzyme (ACE) inhibitors are associated with reduced mortality and cardiovascular events in patients with diabetes, while angiotensin-receptor blockers (ARBs) have little effect, according to a meta-analysis in JAMA Internal Medicine.

Researchers assessed the results of 35 randomized, controlled studies comprising some 56,000 patients. Participants had been randomized to either the active group (ACE inhibitors or ARBs) or a comparator group (placebo, no treatment, or other antihypertensive drugs).

Use of ACE inhibitors was associated with a 13% to 17% risk reduction in all-cause mortality, cardiovascular mortality, and major cardiovascular events. ARB users did not see a similar benefit. However, ARBs were associated with a 30% risk reduction in heart failure.

The authors conclude that ACE inhibitors "should be considered as first-line therapy to limit the excess mortality and morbidity in this population."

Reader Comments (5)

MARK GRABER Physician, Emergency Medicine, University of Iowa

This is not new information. It has been out in BMJ and elsewhere for years. The sad part is that prescribers don't know about it and keep the same prescribing habits.

Tim Beer, MD Physician, Internal Medicine

In general, it would be helpful to specify whether quoted risk reductions are absolute or relative. Still, a good summary of a good study. Thanks.

B Panda MD Physician, Internal Medicine, Hospital

A good feed back in the overcrowded world of anti hypertensives

andrew Ross MB BS FANZCA Physician, Anesthesiology

Revolutionary as well as evolutionary

JOHN WILLIAMS, MD, JD Physician, Urology, PVT. OFFICE

AGREE COMPLETELY.

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