Impact of Angiotensin Converting Enzyme Inhibitor versus Angiotensin Receptor Blocker on Incidence of New-Onset Diabetes Mellitus in Asians.
10.3349/ymj.2016.57.1.180
- Author:
Ji Young PARK
1
;
Seung Woon RHA
;
Byoung Geol CHOI
;
Se Yeon CHOI
;
Jae Woong CHOI
;
Sung Kee RYU
;
Se Jin LEE
;
Seunghwan KIM
;
Yung Kyun NOH
;
Raghavender Goud AKKALA
;
Hu LI
;
Jabar ALI
;
Ji Bak KIM
;
Sunki LEE
;
Jin Oh NA
;
Cheol Ung CHOI
;
Hong Euy LIM
;
Jin Won KIM
;
Eung Ju KIM
;
Chang Gyu PARK
;
Hong Seog SEO
;
Dong Joo OH
Author Information
1. Department of Cardiology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Angiotensin converting enzyme inhibitor;
angiotensin receptor blocker;
diabetes mellitus
- MeSH:
Adult;
Aged;
Angiotensin Receptor Antagonists/*therapeutic use;
Angiotensin-Converting Enzyme Inhibitors/*therapeutic use;
Asian Continental Ancestry Group/*statistics & numerical data;
Blood Glucose/analysis;
Diabetes Mellitus/*diagnosis/*epidemiology;
Dose-Response Relationship, Drug;
Drug Monitoring/methods;
Female;
Follow-Up Studies;
Humans;
Hypertension/*drug therapy;
Incidence;
Kaplan-Meier Estimate;
Logistic Models;
Male;
Middle Aged;
Multivariate Analysis;
Propensity Score;
Republic of Korea/epidemiology;
Risk Factors
- From:Yonsei Medical Journal
2016;57(1):180-186
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) are associated with a decreased incidence of new-onset diabetes mellitus (NODM). The aim of this study was to compare the protective effect of ACEI versus ARBs on NODM in an Asian population. MATERIALS AND METHODS: We investigated a total of 2817 patients who did not have diabetes mellitus from January 2004 to September 2009. To adjust for potential confounders, a propensity score matched (PSM) analysis was performed using a logistic regression model. The primary end-point was the cumulative incidence of NODM, which was defined as having a fasting blood glucose > or =126 mg/dL or HbA1c > or =6.5%. Multivariable cox-regression analysis was performed to determine the impact of ACEI versus ARB on the incidence of NODM. RESULTS: Mean follow-up duration was 1839+/-1019 days in all groups before baseline adjustment and 1864+/-1034 days in the PSM group. After PSM (C-statistics=0.731), a total 1024 patients (ACEI group, n=512 and ARB group, n=512) were enrolled for analysis and baseline characteristics were well balanced. After PSM, the cumulative incidence of NODM at 3 years was lower in the ACEI group than the ARB group (2.1% vs. 5.0%, p=0.012). In multivariate analysis, ACEI vs. ARB was an independent predictor of the lower incidence for NODM (odd ratio 0.37, confidence interval 0.17-0.79, p=0.010). CONCLUSION: In the present study, compared with ARB, chronic ACEI administration appeared to be associated with a lower incidence of NODM in a series of Asian cardiovascular patients.
