PMID- 29642146
OWN - NLM
STAT- MEDLINE
DCOM- 20180417
LR  - 20210109
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 15
DP  - 2018 Apr
TI  - Comparison of angiotensin-converting enzyme inhibitors and angiotensin II 
      receptor blockers on cardiovascular outcomes in hypertensive patients with type 2 
      diabetes mellitus: A PRISMA-compliant systematic review and meta-analysis.
PG  - e0256
LID - 10.1097/MD.0000000000010256 [doi]
LID - e0256
AB  - BACKGROUND: Previous studies seem to show different effects of 
      angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-receptor 
      blockers (ARBs) on cardiovascular (CV) events in hypertensive patients with type 
      2 diabetes mellitus (T2DM). Our objective was to analyze which are preferable on 
      the incidence of all-cause mortality, CV death, and major CV events in 
      hypertensive patients with T2DM. METHODS: PubMed, MEDLINE, and EMBASE were 
      searched for randomized controlled trials (RCTs) published up to June 2016 with 
      ACEI or ARBs as the intervention for hypertensive patients with T2DM. The primary 
      end points were all-cause mortality and CV death. The secondary end points were 
      myocardial infarction (MI), stroke, heart failure (HF), and CV events. Two 
      investigators extracted the information independently. Data were pooled using a 
      fixed-effects model or a random-effects model if significant heterogeneity was 
      present. RESULTS: A total of 13 trials were included for analysis, 5 ACEI trials 
      (24,976 patients) and 8 ARB trials (22,032 patients) followed for a mean of 3.8 
      years. Treatment with ACEI was associated with significantly reduction in 
      all-cause mortality [odds ratio (OR) 0.87; 95% confidence interval (95% CI), 
      0.80-0.94], CV death (OR 0.81; 95% CI, 0.68-0.98), and other CV outcomes such as 
      MI (0R 0.77; 95% CI, 0.66-0.90), stroke (OR 0.88; 95% CI, 0.78-0.99), HF (OR 
      0.65; 95% CI, 0.47-0.90), and CV events (OR 0.83; 95% CI, 0.73-0.95), whereas 
      ARBs therapy had no significant reduction in the results of many primary and 
      secondary outcomes. CONCLUSION: This meta-analysis suggests that treatment with 
      ACEI showed a significant CV protection for all-cause mortality, CV death, and 
      major CV events, whereas ARBs had no benefits on these outcomes except MI. In 
      consideration of high mortality and morbidity, ACEI was preferable than ARBs on 
      patients with hypertension and T2DM.
FAU - Lv, Xiaodan
AU  - Lv X
AD  - Department of Pharmacy, General Hospital of Shenyang Military Area Command School 
      of Life Science and Biopharmaceutis, Shenyang Pharmaceutical University, 
      Shenyang, China.
FAU - Zhang, Yingshi
AU  - Zhang Y
FAU - Niu, Yixuan
AU  - Niu Y
FAU - Song, Qi
AU  - Song Q
FAU - Zhao, Qingchun
AU  - Zhao Q
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Angiotensin Receptor Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
SB  - IM
MH  - Angiotensin Receptor Antagonists/*pharmacology
MH  - Angiotensin-Converting Enzyme Inhibitors/*pharmacology
MH  - Cardiovascular System/*drug effects
MH  - Diabetes Mellitus, Type 2/*complications
MH  - Humans
MH  - *Hypertension/complications/drug therapy
MH  - Outcome Assessment, Health Care
PMC - PMC5908573
COIS- The authors report no conflicts of interest.
EDAT- 2018/04/12 06:00
MHDA- 2018/04/18 06:00
PMCR- 2018/04/13
CRDT- 2018/04/12 06:00
PHST- 2018/04/12 06:00 [entrez]
PHST- 2018/04/12 06:00 [pubmed]
PHST- 2018/04/18 06:00 [medline]
PHST- 2018/04/13 00:00 [pmc-release]
AID - 00005792-201804130-00009 [pii]
AID - MD-D-17-00481 [pii]
AID - 10.1097/MD.0000000000010256 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Apr;97(15):e0256. doi: 10.1097/MD.0000000000010256.