ACE inhibitors and other antihypertensive drugs in patients with type 2 diabetes

ACE inhibitors reduce the risk of myocardial infarction, cardiovascular events and all-cause mortality in hypertensive patients with type 2 diabetes.

A systematic review including 4 RCTs with a total of 2 180 subjects was abstracted in DARE. The analysis showed a statistically-significant benefit of ACE inhibitors on the outcome of acute myocardial infarction, compared with alternative treatments there was a 63% reduction (P <0.001) and the RR was 0.37 (95% CI: 0.24 to 0.57). On the outcome of cardiovascular events, compared with alternative treatments there was a 51% reduction and the RR was 0.49 (95% CI: 0.36 to 0.67). Also, there was a benefit of ACE inhibitors on the outcome of all-cause mortality, compared with alternative treatments there was a 62% reduction (P=0.010) and the RR was 0.57 (95% CI: 0.38 to 0.87). ACE inhibitors did not appear to be superior to other agents for the outcome of stroke in any of the trials, RR 0.76 (95% CI: 0.48 to 1.22).

The following decision support rules contain links to this evidence summary:

• ACE inhibitors or angiotensin-receptor blockers for patients with diabetes and hypertension but no microalbuminuria

Ədəbiyyat

1. Pahor M, Psaty BM, Alderman MH, Applegate WB, Williamson JD, Furberg CD. Therapeutic benefits of ACE inhibitors and other antihypertensive drugs in patients with type 2 diabetes. Diabetes Care 2000 Jul;23(7):888-92.