title: Effectiveness of angiotensin II receptor antagonists in a cohort of Dutch patients with type 2 diabetes mellitus (ZODIAC-14).
abstract: OBJECTIVE
  There is limited evidence with respect to the between-group effects of various angiotensin receptor blockers (ARBs) on blood pressure and albuminuria in patients with type 2 diabetes mellitus. Therefore, we aimed to investigate the effects of differing ARBs on systolic blood pressure (SBP) and the albumin-creatinine ratio after 1 year in a large cohort of patients with type 2 diabetes mellitus.
  
  
  METHODS
  In 2007, 24 940 primary care patients with type 2 diabetes mellitus participated in the Zwolle Outpatient Diabetes project Integrating Available Care (ZODIAC) study, a prospective observational cohort study. Patients were included in the current study if they were prescribed an ARB in 2007 and if 1-year follow-up data were available. The final study population comprised 3610 patients. Multivariate mixed-model analyses were performed to estimate effects of the various ARBs on SBP and albuminuria. Stratified subgroup analyses were performed according to baseline hypertension and albuminuria.
  
  
  RESULTS
  SBP decreased in all groups, the largest decrease being observed in the group receiving telmisartan. No significant or relevant changes over time were observed among groups for SBP and albuminuria. In the subgroup (n=1225) of normotensive patients, telmisartan was associated with a larger decrease in SBP after 1 year compared to other ARBs, without different effects on the albumin-creatinine ratio.
  
  
  CONCLUSIONS
  We observed no differences in effects on SBP and the albumin-creatinine ratio among differing ARBs in patients with type 2 diabetes mellitus.
authors.affiliation: Diabetes Centre, Isala, Zwolle, The Netherlands. Electronic address: k.j.j.van.hateren@isala.nl.
authors.forename: Kornelis J J
authors.initials: KJ
authors.lastname: van Hateren
authors.affiliation: Diabetes Centre, Isala, Zwolle, The Netherlands.
authors.forename: Gijs W D
authors.initials: GW
authors.lastname: Landman
authors.affiliation: Diabetes Centre, Isala, Zwolle, The Netherlands; Department of General Practice, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Klaas H
authors.initials: KH
authors.lastname: Groenier
authors.affiliation: Diabetes Centre, Isala, Zwolle, The Netherlands; Department of Internal Medicine, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands; Department of Internal Medicine, Isala Clinics, Zwolle, The Netherlands.
authors.forename: Henk J G
authors.initials: HJ
authors.lastname: Bilo
authors.affiliation: Diabetes Centre, Isala, Zwolle, The Netherlands; Department of Internal Medicine, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands; Langerhans Medical Research Group, The Netherlands.
authors.forename: Nanne
authors.initials: N
authors.lastname: Kleefstra
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies
chemical_list: D057911:Angiotensin Receptor Antagonists
keywords: albuminuria; albuminurie; angiotensin II receptor antagonists; antagonistes des récepteurs de l'angiotensine II; diabète sucré de type 2; hypertension; observational studies; type 2 diabetes mellitus; études observationnelles