Key result
Angiotensin receptor blocker (ARB) use significantly reduced the risk of cardiovascular mortality, non-fatal MI, and non-fatal stroke compared to non-use (HR 0.53; 95% CI 0.34-0.83; p=0.006).
Why the study?
ARB, ACEI, CCB, and TD are common antihypertensive drugs for diabetes with hypertension, but their comparative cardiovascular risks in patients with isolated systolic hypertension and T2DM remained to be determined.
Do different antihypertensive drugs (ARB, ACEI, CCB, TD) reduce cardiovascular risk in patients with isolated systolic hypertension and type 2 diabetes mellitus?
Observational
Do different antihypertensive drugs (ARB, ACEI, CCB, TD) reduce cardiovascular risk in patients with isolated systolic hypertension and type 2 diabetes mellitus?
Answers are grounded in this paper and cite their sources.
In patients with isolated systolic hypertension and type 2 diabetes, ARB use is associated with reduced cardiovascular mortality, whereas ACEI, CCB, and thiazide diuretics did not show significant cardiovascular benefit in this analysis.
Backgrounds: Angiotensin receptor blockers (ARB), angiotensin converting enzyme inhibitor (ACEI), calcium channel blocker (CCB) and thiazide diuretics (TD) are common antihypertensive drugs for diabetes patients with hypertension. The purpose of this study was to compare the cardiovascular risks of these drugs in patients with isolated systolic hypertension (ISH) and type 2 diabetes mellitus (T2DM). Methods: We used Action to Control Cardiovascular Risk in Diabetes trial data to explore the relationship between antihypertensive drugs and cardiovascular risks in ISH with T2DM patients by performing propensity score matching, Kaplan–Meier survival analyses and Cox proportional regression. Results: The cumulative incidence rates of primary outcomes (PO, including cardiovascular mortality, non-fatal myocardial infarction and non-fatal stroke) in the ARB use group were significantly lower than those without (hazard ratio (HR) 0.53; 95% confidence interval (CI) 0.34–0.83; p = 0.006). However, for ACEI, CCB and TD, they were negligible (ACEI: p = 0.209; CCB: p = 0.245; TD: p = 0.438). ARB decreased cardiovascular mortality (CM) in PO rather than non-fatal myocardial infarction (NMI) and non-fatal stroke (NST) (CM: HR 0.32; 95%CI 0.18–0.90; p = 0.004; NMI: p = 0.692; NST: p = 0.933). Conclusion: ARB may alleviate the cardiovascular risks in ISH with T2DM patients, but ACEI, CCB, and TD did not.
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Gao et al. (2022) conducted an observational in Isolated systolic hypertension (ISH) and type 2 diabetes mellitus (T2DM). Angiotensin receptor blockers (ARB) vs. No ARB use was evaluated on Cardiovascular mortality, non-fatal myocardial infarction and non-fatal stroke (HR 0.53, 95% CI 0.34-0.83, p=0.006). Angiotensin receptor blocker (ARB) use significantly reduced the risk of cardiovascular mortality, non-fatal MI, and non-fatal stroke compared to non-use (HR 0.53; 95% CI 0.34-0.83; p=0.006).
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