ArticleJournal of general internal medicine2006
Indications for and utilization of ACE inhibitors in older individuals with diabetes. Findings from the National Health and Nutrition Examination Survey 1999 to 2002.
Article in Journal of general internal medicine, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Improving quality of care for persons with diabetes: an overview of systematic reviews - what does the evidence tell us?Systematic reviews · 2013Pooled it
- Using pharmacists to improve risk stratification and management of stage 3A chronic kidney disease: a feasibility study.BMC nephrology · 2016Trial
- Article
- Designing and validating a clinical decision support algorithm for diabetic nephroprotection in older patients.BMJ health & care informatics · 2024Article
- Utilization of angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) in patients diagnosed with diabetes: Analysis from the National Ambulatory Medical Care Survey.Preventive medicine reports · 2016Article
- Relationship Between Medication Adherence and Distance to Dispensing Pharmacies and Prescribers Among an Urban Medicaid Population with Diabetes Mellitus.Pharmacotherapy · 2016Article
- ACEI/ARB underused in patients with type 2 diabetes in Chinese population (CCMR-3B study).PloS one · 2015Article
- Achievement of cardiometabolic goals among diabetic patients in Spain. A nationwide population-based study.PloS one · 2013Article
- ACE inhibitor and ARB medication use among Medicaid enrollees with diabetes.Ethnicity & disease · 2013Article
- Factors affecting conformity to renin-angiotensin system inhibitor usage in chronic kidney disease and diabetes mellitus.Journal of clinical hypertension (Greenwich, Conn.) · 2011Article
- High-risk diabetic patients in Medicare Part D programs: are they getting the recommended ACEI/ARB therapy?Journal of general internal medicine · 2010Article
- Use of medications to reduce cardiovascular risk among individuals with psychotic disorders and Type 2 diabetes.Schizophrenia research · 2008Article
- Trends over 5 years in cardiovascular medicine use in Australian veterans with diabetes.British journal of clinical pharmacology · 2007Article
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Abstract
backgroundAngiotensin-converting enzyme inhibitors (ACE) and angiotensin receptor blockers (ARB) improve cardiovascular outcomes in high-risk individuals with diabetes. Despite the marked benefit, it is unknown what percentage of patients with diabetes would benefit from and what percentage actually receive this preventive therapy.
objectivesTo examine the proportion of older diabetic patients with indications for ACE or ARB (ACE/ARB). To generate national estimates of ACE/ARB use. DESIGN AND
participantsSurvey of 742 individuals> or =55 years (representing 8.02 million U.S. adults) self-reporting diabetes in the 1999 to 2002 National Health and Nutrition Examination Survey. MEASUREMENTS: Prevalence of guideline indications (albuminuria, cardiovascular disease, hypertension) and other cardiac risk factors (hyperlipidemia, smoking) with potential benefit from ACE/ARB. Prevalence of ACE/ARB use overall and by clinical indication.
resultsNinety-two percent had guideline indications for ACE/ARB. Including additional cardiac risk factors, the entire (100%) U.S. noninstitutionalized older population with diabetes had indications for ACE/ARB. Overall, 43% of the population received ACE/ARB. Hypertension was associated with higher rates of ACE/ARB use, while albuminuria and cardiovascular disease were not. As the number of indications increased, rates of use increased, however, the maximum prevalence of use was only 53% in individuals with 4 or more indications for ACE/ARB.
conclusionsACE/ARB is indicated in virtually all older individuals with diabetes; yet, national rates of use are disturbingly low and key risk factors (albuminuria and cardiovascular disease) are being missed. To improve quality of diabetes care nationally, use of ACE/ARB therapy by ALL older diabetics may be a desirable addition to diabetes performance measurement sets.
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