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ARB diabetes risk ‘greater in women’

Angotensin receptor blockers are no more effective than ACE inhibitors, and have a greater risk of diabetes say researchers.

Their study looked at the outcomes of over 23,000 adult patients with hypertension receiving an ACE inhibitor or an ARB from clinic electronic records.

The US researchers examined differences in mortality and new-onset coronary disease, chronic kidney disease and stroke. No significant differences were found in any of the groups between those prescribed with ACE inhibitors or those prescribed with ARBs.

But patients prescribed with ARBs had a significantly increased risk of developing new-onset diabetes compared with those taking an ACE inhibitor, with a hazard ratio of 1.28.

This risk was especially high in women taking ARBs, who had a 93% increased risk compared with those on ACE inhibitors.

Study leader Professor Jason Roy, assistant professor of biostatistics at the University of Pennsylvania, said: ‘Results from this study can help guide clinician decision-making, as we compared ACE inhibitors and ARBs on several key outcomes, with long follow-up times, for patient subgroups defined by sex and age.

‘Our finding of a greater risk of new-onset diabetes among ARB users relative to ACE inhibitor users, especially among women, warrants further investigation.'

Journal of Clinical Hypertension, online 3 February

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