ACE Inhibitors best for hypertension in diabetes
Comparative effectiveness of renin-angiotensin system blockers and other antihypertensive drugs in patients with diabetes: systematic review and bayesian network meta-analysis | BMJ
Hon-Yen Wu et al
BMJ 2013;347:f6008
A meta-analysis of 63 trials with 36 917 participants, looking at survival and reno-protection, concluded that ACE inhibitors should be first line treatment in people with diabetes.
Conclusion:
Our analyses show the renoprotective effects and superiority of using ACE inhibitors in patients with diabetes, and available evidence is not able to show a better effect for ARBs compared with ACE inhibitors. Considering the cost of drugs, our findings support the use of ACE inhibitors as the first line antihypertensive agent in patients with diabetes. Calcium channel blockers might be the preferred treatment in combination with ACE inhibitors if adequate blood pressure control cannot be achieved by ACE inhibitors alone.