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An angiotensin II antagonist (AIIA) is as effective as an ACE inhibitor in protecting patients with type 2 diabetes from deteriorating renal function, new research has found.

The DETAIL study, published in last week's New England Journal of Medicine, also found that both drugs cut the risk of cardiovascular mortality over five years from 35 per cent to less than 5 per cent.

The DETAIL study compared the AIIA telmisartan with ACE inhibitor enalapril in 252 patients with type 2 diabetes, hypertension and nephropathy.

Researchers found that after five years, the mean fall in glomerular filtration rate for telmisartan was 17.9ml/min/ 1.73m2, at least as good as the 14.8ml/min/1.73m2 observed for enalapril.

Principal study author Professor Anthony Barnett, clinical director of diabetes and endocrinology at Birmingham Heartlands and Solihull Hospitals, said the results showed that telmisartan was a 'valid choice for first-line treatment'.

'The fact that telmisartan is comparable to enalapril is particularly encouraging in view of the superior tolerability profile of AIIAs compared with ACE inhibitors,' he said.

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