Antihypertensive ACEIs associated with reduced cardiovascular events, death

The blood pressure medication angiotensin-converting enzyme inhibitors (ACEIs) appear to reduce major cardiovascular events and death, as well death from all other causes, in patients with diabetes, while angiotensin II receptor blockers (ARBs) appear to have no such effect on those outcomes.

Approximately 285 million adults worldwide have diabetes, and diabetes is a risk factor for cardiovascular diseases (CV). The American Diabetes Association recommends that patients with diabetes and high be treated with an ACEI or an ARB.

The authors examined the available medical literature to conduct a meta-analysis that examined the effects of ACEIs and ARBs on major CV events and death, as well as death from all other causes. The authors identified 35 clinical trials: 23 compared ACEIs with placebo or other active drugs (n=32,827 patients) and 13 other trials compared ARBs with no therapy (controls) (n=23,867 patients).

An analysis of the suggests that ACEIs reduce the risk of death from all causes by 13 percent, cut the risk CV deaths by 17 percent and lower the risk of major CV events by 14 percent, including myocardial infarction (heart attack) by 21 percent and heart failure by 19 percent. ARBS did not affect all-cause mortality, CV death rate and major CV events, with the exception of . ACEIs and ARBs were not associated with a decreased risk for stroke in patients with diabetes.

"Our meta-analysis shows that ACEIs reduce all-cause mortality, CV mortality and major CV events in patients with DM [diabetes mellitus], whereas ARBs have no beneficial effects on these outcomes. Thus, ACEIs should be considered as first-line therapy to limit the excess mortality and morbidity in this population," Jun Cheng, M.D., of the Medical School of Zhejiang University, China, and colleagues wrote in their JAMA Internal Medicine paper.

More information: JAMA Intern Med. Published online March 31, 2014. DOI: 10.1001/jamainternmed.2014.348

add to favorites email to friend print save as pdf

Related Stories

Many psoriasis patients undertreated for CV risk factors

Jun 22, 2012

(HealthDay) -- A large proportion of patients with moderate-to-severe plaque psoriasis are underdiagnosed and undertreated for cardiovascular (CV) risk factors, according to a study published in the July issue ...

Recommended for you

Results of RIBS IV trial reported

9 hours ago

A new clinical trial comparing the use of everolimus-eluting stents (EES) and drug-eluting balloons (DEB) in treating in-stent restenosis (ISR) from drug-eluting stents found that EES provided superior late angiographic results ...

Results of DKCRUSH-VI trial reported

9 hours ago

A new study found that fractional flow reserve (FFR)-guided provisional side branch (SB) stenting of true coronary bifurcation lesions yields similar outcomes to the current standard of care. The DKCRUSH-VI clinical trial ...

Results of IVUS-CTO trial reported at TCT 2014

9 hours ago

A new study found that intravascular ultrasound (IVUS) -guided intervention in patients with chronic total occlusion (CTO) could improve outcomes compared to a conventional angiography-guided approach during percutaneous ...

Results of OCT STEMI trial reported at TCT 2014

9 hours ago

The first randomized trial to examine serial optical coherence tomography (OCT) in primary percutaneous coronary intervention (PCI) was reported at the 26th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific ...

INR variability predicts warfarin adverse effects

15 hours ago

(HealthDay)—Unstable anticoagulation predicts warfarin adverse effects regardless of time in therapeutic range, according to a study published online Sept. 2 in Circulation: Cardiovascular Quality and Ou ...

User comments