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