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Blood pressure drugs associated with lower risk of heart disease in people with diabetes

Toronto, July 8, 2013

By Kate Taylor

Two commonly used drugs used to reduce blood pressure in people with diabetes have been found to lower the risk of hospitalization for heart attack, stroke or heart failure, according to a study led by researchers at St. Michael’s Hospital.

For people with type 2 diabetes, disease-related vascular illnesses are the main causes of death. Angiotensin-receptor blockers including telmisartan, valsartan, candesartan, irbesartan and losartan, are generally used interchangeably to control blood pressure. However, there is some evidence from small trials that telmisartan has slightly different properties than other angiotensin-receptor blockers and may improve cardiovascular health.

Research led by Dr. Tony Antoniou, a researcher and pharmacist in the Department of Family and Community Medicine, led a first-of-its-kind large scale study to compare the effectiveness of the various angiotensin receptor blockers.

The study looked at data for 54,186 Ontario residents with diabetes over 65 who took angiotensin-receptor blockers between April 1, 2001 and March 31, 2010. They wanted to see if there was a lower risk of cardiovascular illnesses in people taking telmisartan compared with other drugs in the same class.

The results, published in the Canadian Medical Association Journal, found that telmisartan and valsartan were associated with a significantly lower risk of hospitalization for heart attack, stroke or heart failure compared with other angiotensin-receptor blockers.

"Our findings suggest that differences may exist in the effectiveness of angiotensin-receptor blockers when used for the prevention of heart disease in older patients with diabetes,” Dr. Antoniou said. “And that similarity among the individual drugs cannot be assumed when they are used for this reason."

Dr. Antoniou said that although angiotensin-receptor blockers share common structural features, it is the pharmacologic differences between the drugs that may explain the results.

The authors suggest that randomized controlled trials and large observational studies looking at cardiovascular health and deaths in patients taking different angiotensin-receptor blockers are needed.

The study was funded by the Ontario Drug Policy Research Network.

About St. Michael’s Hospital

St Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

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