title: ACEI/ARB underused in patients with type 2 diabetes in Chinese population (CCMR-3B study).
abstract: OBJECTIVE
  In patients with diabetic kidney disease, it is well documented that RAS blockade is associated with an improved outcome. This observational, multicenter study examined the "real-world" use of ACEI/ARB in patients with type 2 diabetes (T2DM) in China.
  
  
  METHODS
  Data from the China Cardiometabolic Registries on blood pressure, blood lipid and blood glucose in Chinese T2DM patients (CCMR-3B) were used for the present study. Consecutive outpatients with T2DM for more than 6 months were recruited to this non-interventional, observational, cross-sectional study. Albuminuria was defined as urine albumin creatinine ratio (ACR) ≥ 30 mg/g.
  
  
  RESULTS
  A total of 25,454 outpatients with T2DM from 6 regions in China were enrolled, 47.0% were male, and 59.8% had hypertension. ACR was measured in 6,383 of these patients and 3,231 of them ≥ 30 mg/L. Among patients with hypertension, 73.0% were on antihypertensives, and 39.7% used ACEI/ARB. Of the 2,157 patients with hypertension and albuminuria, only 48.3% used ACEI/ARB. Among the non-hypertensive patients with albuminuria, ACEI/ARB usage was < 1%. Multivariate analysis revealed that comorbidities, region, hospital tier, physician specialty and patient's educational level were associated with ACEI/ARB use.
  
  
  CONCLUSIONS
  In T2DM with hypertension and albuminuria in China, more than half of them were not treated with ACEI/ARB. This real world evidence suggests that the current treatment for patients with diabetes coexisting with hypertension and albuminuria in China is sub-optimal.
authors: Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China.
authors: Qionghong
authors: Q
authors: Xie
authors: Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China.
authors: Chuan-Ming
authors: CM
authors: Hao
authors: Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China.
authors: Linong
authors: L
authors: Ji
authors: Department of Cardiology, Peking University People's Hospital, Beijing, China.
authors: Dayi
authors: D
authors: Hu
authors: Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China.
authors: Tongying
authors: T
authors: Zhu
authors: VitalStrategic Research Institute, Berwyn, PA, United States of America.
authors: Xuehai
authors: X
authors: Li
authors: VitalStrategic Research Institute, Berwyn, PA, United States of America.
authors: Dandan
authors: D
authors: Qin
authors: VitalStrategic Research Institute, Berwyn, PA, United States of America.
authors: Danyi
authors: D
authors: Zhang
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D044466:Asian People; D002681:China / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors