Similar reduction in new cases of type 2 diabetes with angiotensin receptor blocker and ACE inhibitor: comparison of meta-analyses of prospective randomised trials
Scheen, A.J.
Revue Medicale de Liege 60(5-6): 424-428
2005
ISSN/ISBN: 0370-629X PMID: 16035305 Document Number: 586673
This paper aims at comparing two meta-analyses of clinical trials having investigated the effect of the inhibition of the renin-angiotensin system either with an angiotensin converting enzyme inhibitor (ACEI) or with a selective angiotensin receptor blocker (ARB) on the incidence of new cases of type 2 diabetes mellitus in subjects with arterial hypertension or with congestive heart failure. The protection appears similar with ACEIs in six trials in a total of 24.623 patients (hazard ratio: 0.77; CI 95% 0.72-0.81; p < 0.00001 and with ARBs in five trials in a total of 14.344 patients (hazard ratio: 0.79; CI 95% 0.73-0.85; p < 0.00001). It is consistent whatever the comparator, a thiazide diuretic agent, a beta-blocker, a dihydropyridine calcium channel blocker or a placebo. The large ongoing ONTARGET controlled study will allow a direct comparison between an ACEI, ramipril, and an ARB, telmisartan, and will also investigate the potential benefit of a combined treatment with both drugs. The inhibition of the renin-angiotensin system should be considered among pharmacological strategies of prevention of type 2 diabetes mellitus.