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Effects of ACEI/ARB in hypertensive patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled studies.

Hao G, Wang Z, Guo R, Chen Z, Wang X, Zhang L, Li W - BMC Cardiovasc Disord (2014)

Bottom Line: Two investigators independently extracted the information with either fixed-effect model or random-effect model to assess the effects of ACE/ARBs treatment in hypertensive patients with T2 DM.Overall, treatment with ACE/ARBs in hypertensive patients with T2 DM was associated with a statistically significant 10% reduction in CV events, pooled hazard ratio (HR) of 0.90 [95% confidence intervals (CI): 0.82-0.98] with no heterogeneity (I2 = 19.50%; P = 0.275);and 17% reduction in CV mortality, pooled HR of 0.83 [95% CI: 0.72-0.96] with no heterogeneity (I2 = 0.9%; P = 0.388).Treatment with ACE/ARBs results in significant reduction in CV events and mortality in hypertensive patients with T2 DM.

View Article: PubMed Central - PubMed

Affiliation: Division of Prevention & Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No, 167 Beilishi Road Xicheng District, Beijing 100037, China. wangzengwu@foxmail.com.

ABSTRACT

Background: The effects of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) on cardiovascular (CV) risk in hypertensive patients with type 2 diabetes mellitus (T2 DM) are uncertain. Our objective was to analyze the effects of ACE/ARBs, on the incidence of myocardial infarction, stroke, CV events, and all-cause mortality in hypertensive patients with T2 DM.

Method: PubMed and Embase databases were searched through January 2014 to identify studies meeting a priori inclusion criteria and references in the published articles were also reviewed. Two investigators independently extracted the information with either fixed-effect model or random-effect model to assess the effects of ACE/ARBs treatment in hypertensive patients with T2 DM.

Results: Ten randomized controlled studies were included with a total of 21,871 participants. Overall, treatment with ACE/ARBs in hypertensive patients with T2 DM was associated with a statistically significant 10% reduction in CV events, pooled hazard ratio (HR) of 0.90 [95% confidence intervals (CI): 0.82-0.98] with no heterogeneity (I2 = 19.50%; P = 0.275);and 17% reduction in CV mortality, pooled HR of 0.83 [95% CI: 0.72-0.96] with no heterogeneity (I2 = 0.9%; P = 0.388). ACE/ARBs was not associated with MI, stroke and all-cause mortality.

Conclusions: Treatment with ACE/ARBs results in significant reduction in CV events and mortality in hypertensive patients with T2 DM.

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Related in: MedlinePlus

All-cause mortality (a), CV mortality (b), MI (c), stroke (d), and CV events (e) treatment effect of ACE/ARBs in all included trials. CV = cardiovascular, MI = myocardial infarction, HR = hazard ratio, CI = confidence interval.
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Fig2: All-cause mortality (a), CV mortality (b), MI (c), stroke (d), and CV events (e) treatment effect of ACE/ARBs in all included trials. CV = cardiovascular, MI = myocardial infarction, HR = hazard ratio, CI = confidence interval.

Mentions: Treatment with ACE/ARBs did not reduce significantly all-cause mortality (HR: 0.91, 95% CI: 0.83-1.00, P = 0.062); the degree of heterogeneity in the treatment effect across all trials was low (I2 = 21.0%) and non-significant (P = 0.210, Figure 2a).Figure 2


Effects of ACEI/ARB in hypertensive patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled studies.

Hao G, Wang Z, Guo R, Chen Z, Wang X, Zhang L, Li W - BMC Cardiovasc Disord (2014)

All-cause mortality (a), CV mortality (b), MI (c), stroke (d), and CV events (e) treatment effect of ACE/ARBs in all included trials. CV = cardiovascular, MI = myocardial infarction, HR = hazard ratio, CI = confidence interval.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4221690&req=5

Fig2: All-cause mortality (a), CV mortality (b), MI (c), stroke (d), and CV events (e) treatment effect of ACE/ARBs in all included trials. CV = cardiovascular, MI = myocardial infarction, HR = hazard ratio, CI = confidence interval.
Mentions: Treatment with ACE/ARBs did not reduce significantly all-cause mortality (HR: 0.91, 95% CI: 0.83-1.00, P = 0.062); the degree of heterogeneity in the treatment effect across all trials was low (I2 = 21.0%) and non-significant (P = 0.210, Figure 2a).Figure 2

Bottom Line: Two investigators independently extracted the information with either fixed-effect model or random-effect model to assess the effects of ACE/ARBs treatment in hypertensive patients with T2 DM.Overall, treatment with ACE/ARBs in hypertensive patients with T2 DM was associated with a statistically significant 10% reduction in CV events, pooled hazard ratio (HR) of 0.90 [95% confidence intervals (CI): 0.82-0.98] with no heterogeneity (I2 = 19.50%; P = 0.275);and 17% reduction in CV mortality, pooled HR of 0.83 [95% CI: 0.72-0.96] with no heterogeneity (I2 = 0.9%; P = 0.388).Treatment with ACE/ARBs results in significant reduction in CV events and mortality in hypertensive patients with T2 DM.

View Article: PubMed Central - PubMed

Affiliation: Division of Prevention & Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No, 167 Beilishi Road Xicheng District, Beijing 100037, China. wangzengwu@foxmail.com.

ABSTRACT

Background: The effects of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) on cardiovascular (CV) risk in hypertensive patients with type 2 diabetes mellitus (T2 DM) are uncertain. Our objective was to analyze the effects of ACE/ARBs, on the incidence of myocardial infarction, stroke, CV events, and all-cause mortality in hypertensive patients with T2 DM.

Method: PubMed and Embase databases were searched through January 2014 to identify studies meeting a priori inclusion criteria and references in the published articles were also reviewed. Two investigators independently extracted the information with either fixed-effect model or random-effect model to assess the effects of ACE/ARBs treatment in hypertensive patients with T2 DM.

Results: Ten randomized controlled studies were included with a total of 21,871 participants. Overall, treatment with ACE/ARBs in hypertensive patients with T2 DM was associated with a statistically significant 10% reduction in CV events, pooled hazard ratio (HR) of 0.90 [95% confidence intervals (CI): 0.82-0.98] with no heterogeneity (I2 = 19.50%; P = 0.275);and 17% reduction in CV mortality, pooled HR of 0.83 [95% CI: 0.72-0.96] with no heterogeneity (I2 = 0.9%; P = 0.388). ACE/ARBs was not associated with MI, stroke and all-cause mortality.

Conclusions: Treatment with ACE/ARBs results in significant reduction in CV events and mortality in hypertensive patients with T2 DM.

Show MeSH
Related in: MedlinePlus