Association of angiotensin-converting enzyme inhibitor therapy and comorbidity in diabetes: results from the Vermont diabetes information systemReport as inadecuate




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BMC Endocrine Disorders

, 8:17

First Online: 05 December 2008Received: 11 September 2008Accepted: 05 December 2008

Abstract

BackgroundAngiotensin converting enzyme inhibitors ACE inhibitors reduce peripheral vascular resistance via blockage of angiotensin converting enzyme ACE. ACE inhibitors are commonly used to treat congestive heart failure and high blood pressure, but other effects have been reported. In this study, we explored the association between ACE inhibitor therapy and the prevalence of comorbid conditions in adults with diabetes

MethodsWe surveyed 1003 adults with diabetes randomly selected from community practices. Patients were interviewed at home and self-reported their personal and clinical characteristics including comorbidity. Current medications were obtained by direct observation of medication containers. We built logistic regression models with the history of comorbidities as the outcome variable and the current use of ACE inhibitors as the primary predictor variable. We adjusted for possible confounding by social age, sex, alcohol drinking, cigarette smoking and clinical factors systolic blood pressure, body mass index BMI, glycosolated hemoglobin A1C, number of comorbid conditions, and number of prescription medications.

ResultsACE users reported a history of any cancer except the non-life-threatening skin cancers less frequently than non-users 10% vs. 15%; odd ratio = 0.59; 95% confidence interval 0.39, 0.89; P = 0.01; and a history of stomach ulcers or peptic ulcer disease less frequently than non-users 12% vs. 16%, odd ratio = 0.70, 0.49, 1.01, P = 0.06. After correcting for potential confounders, ACE inhibitors remained significantly inversely associated with a personal history of cancer odds ratio = 0.59, 0.39, 0.89; P = 0.01 and peptic ulcer disease odd ratio = 0.68, 0.46, 1.00, P = 0.05.

ConclusionACE inhibitor use is associated with a lower likelihood of a history of cancer and peptic ulcers in patients with diabetes. These findings are limited by the cross sectional study design, self-report of comorbid diagnoses, and lack of information on the timing and duration of ACE inhibitor use. Further research is needed to confirm these associations and understand their mechanisms.

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Author: Maria E Ramos-Nino - Charles D MacLean - Benjamin Littenberg

Source: https://link.springer.com/







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