Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Siebenhofer, A; Plank, J; Horvath, K; Berghold, A; Sutton, AJ; Sommer, R; Pieber, TR.
Angiotensin receptor blockers as anti-hypertensive treatment for patients with diabetes mellitus: meta-analysis of controlled double-blind randomized trials.
DIABETIC MED. 2004; 21(1): 18-25.
Doi: 10.1111/j.1464-5491.2004.01122.x
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
- Siebenhofer-Kroitzsch Andrea
- Co-Autor*innen der Med Uni Graz
- Berghold Andrea
- Horvath Karl
- Pieber Thomas
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- Abstract:
- AIMS: To assess the evidence for possible reduction of all-cause mortality, cardiovascular morbidity and mortality, and end-stage renal disease in diabetic patients treated with angiotensin II type 1 receptor blockers (ARBs) as an anti-hypertensive treatment. METHODS: Systematic review and meta-analysis of randomized, double-blind controlled trials of at least 1 year's duration. ARBs were used in the intervention group vs. placebo or standard anti-hypertensive treatment in the control group. The main outcome measures were all-cause mortality, cardiovascular morbidity and mortality, and end-stage renal disease. RESULTS: Three studies fulfilled the inclusion criteria. Separate analyses were conducted for comparisons of ARBs with groups given placebo and those given standard anti-hypertensive treatment. There was no significant difference in mortality between the ARBs and placebo groups, with an estimated odds ratio (OR) of 0.99 [95% confidence interval (CI) 0.81, 1.20]. There was a non-significant difference in patients treated with ARBs compared with standard anti-hypertensive treatment, with an OR of 0.78 (95% CI 0.45, 1.36). No statistically significant difference in cardiovascular morbidity and mortality between the intervention and placebo groups was found, with an OR of 0.91 (95% CI 0.77, 1.08). When ARBs were compared with standard treatment, the OR was estimated at 0.85 (0.54, 1.33). Data on end-stage renal disease were available for two studies comparing ARBs vs. placebo and showed a statistically significant advantage of ARBs, with an OR of 0.73 (95% CI 0.6, 0.89). As only one study compared end-stage renal disease outcome for ARBs vs. standard treatment, a meta-analysis was not possible. This study reported a considerable benefit of ARBs [OR = 0.73 (0.54, 1.01)] compared with the calcium channel blocker amlodipine. CONCLUSIONS: ARBs failed to show significant reduction in total mortality and cardiovascular morbidity and mortality in diabetic patients. The only statistical benefit was the reduction of end-stage renal disease compared with placebo. Therefore, at this time ARBs have not proved to be superior to standard anti-hypertensive treatment in diabetic patients.
- Find related publications in this database (using NLM MeSH Indexing)
- Angiotensin II - metabolism
- Angiotensin II Type 1 Receptor Blockers - metabolism
- Antihypertensive Agents - therapeutic use
- Diabetic Angiopathies - mortality
- Diabetic Nephropathies - mortality
- Double-Blind Method - mortality
- Humans - mortality
- Kidney Failure, Chronic - mortality
- Morbidity - mortality
- Randomized Controlled Trials - mortality
- Find related publications in this database (Keywords)
- diabetes
- angiotensin receptor blockers
- meta-analysis