Key result
ACEIs/ARBs and CCBs linked to higher sight-threatening diabetic retinopathy risk vs β-blockers.
Why the study?
Does the use of ACEIs/ARBs or CCBs compared to beta-blockers reduce the development of sight-threatening diabetic retinopathy in patients with type 2 diabetes and hypertension?
Cohort
Does the use of ACEIs/ARBs or CCBs compared to beta-blockers reduce the development of sight-threatening diabetic retinopathy in patients with type 2 diabetes and hypertension?
In patients with type 2 diabetes and hypertension, ACEIs/ARBs and CCBs were associated with a higher risk of sight-threatening diabetic retinopathy compared to beta-blockers, challenging the assumption of their microvascular superiority in this specific outcome.
Answers are grounded in this paper and cite their sources.
May warrant caution selecting antihypertensives in type 2 diabetes; leaves open whether ACEIs/ARBs or CCBs causally increase sight-threatening diabetic retinopathy risk versus β-blockers.
OBJECTIVE: To evaluate the association between the development of sight-threatening diabetic retinopathy (STDR) and antihypertensive drugs (AHDs) use among type 2 diabetic patients with concomitant hypertension. METHODS: Type 2 diabetic patients aged 20-100 years who had at least one prescription for AHDs between 2000 and 2011 were identified from the Longitudinal Health Insurance Database (LHID) 2005. The incidence rates of STDR were followed and Cox proportional hazard models were used to analyze the risk associated with AHDs. RESULTS: Users of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) were associated with a significantly higher risk than users of calcium channel blockers (CCBs), independent of baseline characteristics. After adjusting for time-varying use of concomitant medications for propensity score-matched or -unmatched cohorts, the results showed that patients receiving ACEIs/ARBs and CCBs were associated with a significantly greater risk compared with β-blocker users. CONCLUSIONS: Our study did not support a superiority of ACEIs/ARBs and CCBs over β-blockers for lowering the progression of diabetic retinopathy.
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Lin et al. (2015) conducted a cohort in Type 2 diabetes with concomitant hypertension. ACEIs/ARBs and CCBs vs. β-blockers was evaluated on Development of sight-threatening diabetic retinopathy (STDR). Use of ACEIs/ARBs and CCBs was associated with a significantly greater risk of developing sight-threatening diabetic retinopathy compared with β-blockers in patients with type 2 diabetes.
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