title: Angiotensin-converting enzyme inhibitors versus angiotensin receptor blockers for end-stage renal disease/mortality in type 2 diabetes.
abstract: OBJECTIVE
  To compare angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) for end-stage renal disease (ESRD) development and all-cause mortality in veterans with macroalbuminuria and with newly documented type 2 diabetes.
  
  
  METHODS
  A retrospective cohort study utilizing data from the national Department of Veterans Affairs (VA) databases. The study followed 5166 subjects without a history of use of ACEIs or ARBs. To control for differences in baseline characteristics between groups, comparisons of subjects ACEIs and ARBs were made by incorporating propensity scores analysis into multivariate logistic regression. This resulted in adjusted odds ratios and 95% confidence intervals for ESRD development and all-cause mortality.
  
  
  RESULTS
  The sample was followed up to five years with a mean follow-up of three years. Subjects taking ACEIs has lower odds of ESRD development (OR, 0.33 [95% CI, 0.13-0.82]) and all-cause mortality (OR, 0.10 [95% CI, 0.04-0.21]) than ARBs.
  
  
  CONCLUSIONS
  This study shows that ACEIs are associated with lower ESRD development and all-cause mortality than ARBs. This may have implications for guidelines which currently suggest that these two therapeutic classes provide similar benefits in people with newly diagnosed type 2 diabetes and macroalbuminuria.
authors.affiliation: VA Cooperative Studies Program, Clinical Research Pharmacy Coordinating Center, Albuquerque, NM, United States; University of New Mexico College of Pharmacy, Albuquerque, NM, United States. Electronic address: heather.campbell@va.gov.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Campbell
authors.forename: Nasreen
authors.initials: N
authors.lastname: Khan
authors.forename: Dennis W
authors.initials: DW
authors.lastname: Raisch
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Borrego
authors.forename: Mike R
authors.initials: MR
authors.lastname: Sather
authors.forename: Glen H
authors.initials: GH
authors.lastname: Murata
mesh_terms: D057911:Angiotensin Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D002423:Cause of Death; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000139:chemically induced / Q000378:metabolism / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors
keywords: ACEI; ARB; Angiotensin receptor blocker; Angiotensin-converting enzyme inhibitor