Effect of angiotensin receptor blockers in the prevention of type 2 diabetes and cardiovascular events: a meta-analysis of randomized trials

Chinese Medical Journal, 05/31/2012

Hui-fen S et al. - Angiotensin receptor blockers (ARBs) have significant ability to reduce risk of developing new-onset type 2 diabetes but does not improve cardiovascular outcomes over the study follow-up periods among all of included studies.

Methods

  • Relevant experimental and clinical studies were identified by searching MEDLINE (1969 to May 30, 2011) to extract a consensus of trial data involving the effect of ARBs on prevention of new-onset type 2 diabetes and cardiovascular events.
  • Studies were included if they were randomized controlled trials versus placebo/routine therapy.
  • A random-effects model was utilized.
  • Subgroup and sensitivity analyses were conducted.
  • Eleven trials were identified, including 82 738 patients.

Results

  • ARBs prevented new-onset type 2 diabetes (odds ratio 0.8 (95% CI 0.76, 0.85)).
  • Regardless of indication for use, essential hypertension (seven trials), impaired glucose tolerance (one trial), cardiocerebrovascular disease (two trials) or heart failure (one trial), reductions in new-onset type 2 diabetes were maintained (0.75 (0.69, 0.82), 0.85 (0.78, 0.92), 0.80 (0.76, 0.85) and 0.80 (0.64, 0.99), respectively).
  • No statistical heterogeneity was observed for any evaluation.
  • However, ARBs did not significantly reduce the odds of all-cause mortality, myocardial infarction and heart failure versus control therapy among all of these studies.
  • But ARBs did reduce the odds of cardiac death and heart failure among the heart failure study versus control therapy.

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