Key result
ACE inhibitor regimens were associated with a lower risk of new-onset type-2 diabetes compared with non-ACE inhibitor regimens in hypertensive patients.
Why the study?
Do ACE inhibitor regimens reduce the incidence of new-onset type-2 diabetes mellitus compared to non-ACE inhibitor regimens in patients newly diagnosed with hypertension?
Cohort (n=98,629)
Do ACE inhibitor regimens reduce the incidence of new-onset type-2 diabetes mellitus compared to non-ACE inhibitor regimens in patients newly diagnosed with hypertension?
In patients newly diagnosed with hypertension, ACE inhibitor-based regimens are associated with a lower risk of new-onset type-2 diabetes compared to non-ACE inhibitor regimens.
Answers are grounded in this paper and cite their sources.
ACE inhibitor regimens in new hypertension may lower diabetes risk; observational data leave open need for RCTs before changing practice.
PURPOSE: To evaluate the effect of antihypertensive drugs on new-onset type-2 diabetes. METHODS: This was a cohort study using the UK General Practice Research Database (GPRD). Patients newly diagnosed with hypertension between 1991 and 2001, and treated with antihypertensive drugs, were included. Type-2 diabetes mellitus was identified based on a physician diagnosis or an anti-diabetic drug prescription. Antihypertensive treatments were classified as: ACE inhibitors (ACE-Is), beta blockers, calcium channel blockers (CCB), thiazides, all other drugs, and their combinations. RESULTS: A total of 2706 incident diabetes cases were identified in 98 629 hypertensive patients during 307 356 patient years (8.8/1000 patient years). New-onset diabetes was lower for ACE-I regimens compared with non-ACE inhibitor regimens (HR = 0.90; 95%CI: 0.82-0.99). CCB monotherapy (HR = 1.27; 95%CI: 1.07-1.51) had an increased risk of diabetes compared with ACE-I monotherapy. ACE-I plus thiazide had the lowest risk of diabetes among double combinations, followed by ACE-I plus beta blocker, and ACE-I plus CCB. Double combinations with an ACE-I had 0.79 (95%CI: 0.67-0.92) times the risk compared with non-ACE inhibitor combinations. The risk of new-onset diabetes was significantly higher for beta blocker plus thiazide (HR = 1.37; 1.10-1.70), CCB plus thiazide (HR = 1.44; 95%CI: 1.13-1.83), but not beta blocker plus CCB (HR = 1.30; 95%CI: 0.99-1.70) compared with ACE-I plus thiazide. CONCLUSIONS: Antihypertensive drug combinations including an ACE-I had a significantly lower risk of new-onset diabetes than antihypertensive drug combinations without an ACE-I.
No takes yet. Share an insight, caveat, or question.
Burke et al. (2007) conducted a cohort in hypertension (n=98,629). ACE inhibitor regimens vs. non-ACE inhibitor regimens was evaluated on new-onset type-2 diabetes mellitus (HR 0.90, 95% CI 0.82-0.99). ACE inhibitor regimens were associated with a lower risk of new-onset type-2 diabetes compared with non-ACE inhibitor regimens in hypertensive patients.
Synapse has enriched 10 related papers. Consider them for comparative context: