on July 12, 2004
Published online before print July 12, 2004, doi: 10.1161/01.HYP.0000137192.19577.c3
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on May 18, 2004
From the Departments of Medicine and Therapeutics (W.Y.S., R.O., N.N.C., P.C.Y.T., G.T.C.K., C.C.C., W.B.C., R.C.W.M., J.C.N.C.) and Chemical Pathology (C.S.H., C.W.K.L.), Prince of Wales Hospital, Chinese University of Hong Kong, Special Administrative Region of China. * To whom correspondence should be addressed. E-mail: wingyeeso{at}cuhk.edu.hk.
Abstract--We assessed the effects of angiotensin-converting enzyme (ACE) inhibition on survival and cardiorenal outcomes in a consecutive cohort of Chinese type 2 diabetic patients with varying degree of albuminuria, ranging from normoalbuminuria to macroalbuminuria. A total of 3773 consecutive Chinese type 2 diabetic patients were followed prospectively for a mean period of 35.8 months. Clinical end points included all-cause mortality, with cardiovascular end point defined as first hospitalization because of ischemic heart disease, congestive heart failure, revascularization procedures, or cerebrovascular accident as well as renal end point defined as dialysis, doubling of baseline plasma creatinine, or plasma creatinine
Revised on April 6, 2004
Effect of Angiotensin-Converting Enzyme Inhibition on Survival in 3773 Chinese Type 2 Diabetic Patients
Wing Yee So*;
500 µmol/L. The use of ACE inhibitor was 26.3% in normoalbuminuric (NA), 70.1% in microalbuminuric (MI), and 82.6% in macroalbuminuric (MA) groups. Albuminuria was a major predictor for all-cause mortality with 4-fold difference between NA and MA patients. The 7-year cumulative mortality rate was 7.1%, 10.8%, and 21.7% in the NA, MI, and MA groups, respectively. The use of ACE inhibition was associated with significant reduction of mortality (hazard ratio 0.41 and 95% confidence interval, 0.29, 0.58) in the entire group and was most evident in high-risk patients who had cardiorenal complications or retinopathy at baseline for all albuminuric groups (NA 0.76 [0.31,1.87]; MI 0.32 [0.16, 0.65]; and MA 0.20 [0.13, 0.33]). The prognostic value of albuminuria for death in type 2 diabetes and the beneficial effects of ACE inhibitors in Chinese type 2 diabetic patients with micro- or macroalbuminuria has been confirmed. The effects of ACE inhibitors in type 2 diabetic patients with normoalbuminuria require further evaluation.
Key words: angiotensin-converting enzyme • diabetes mellitus • cardiovascular diseases • renal disease
This article has been cited by other articles:
 |
|
 |
|
  A. P.S. Kong, X. Yang, G. T.C. Ko, W.-Y. So, W.-B. Chan, R. C.W. Ma, V. W.S. Ng, C.-C. Chow, C. S. Cockram, P. C.Y. Tong, et al. Effects of Treatment Targets on Subsequent Cardiovascular Events in Chinese Patients With Type 2 Diabetes Diabetes Care, April 1, 2007; 30(4): 953 - 959. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Y F Wu, W. Y S Leung, S. Chang, B. Lee, B. Zee, P. C Y Tong, and J. C N Chan Effectiveness of telephone counselling by a pharmacist in reducing mortality in patients receiving polypharmacy: randomised controlled trial BMJ, September 9, 2006; 333(7567): 522. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Y. So, A. P.S. Kong, R. C.W. Ma, R. Ozaki, C. C. Szeto, N. N. Chan, V. Ng, C. S. Ho, C. W.K. Lam, C. C. Chow, et al. Glomerular filtration rate, cardiorenal end points, and all-cause mortality in type 2 diabetic patients. Diabetes Care, September 1, 2006; 29(9): 2046 - 2052. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Vora and C. Weston BENEDICT: primary prevention of microalbuminuria in hypertensive type 2 diabetes: Bergamo NEphrologic Diabetes Complication Trial (BENEDICT) The British Journal of Diabetes & Vascular Disease, March 1, 2006; 6(2): 84 - 88. [PDF]
|
|