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Older Diabetics Not Receiving Recommended Medications

Less than half on angiotensin-converting enzyme inhibitors and angiotensin receptor blockers

MONDAY, April 24 (HealthDay News) -- More than half of older diabetics aren't taking angiotensin-converting enzyme inhibitors (ACE) and angiotensin receptor blockers (ARB) to help protect their hearts and kidneys, according to a study published online in the April issue of the Journal of General Internal Medicine.

Allison B. Rosen, M.D., of the University of Michigan Health Systems in Ann Arbor, surveyed 742 patients over age 55 who self-reported diabetes in the 1999 to 2002 National Health and Nutrition Examination Survey.

The researcher found that almost all subjects had guideline indications for ACE/ARB, but that only 43 percent of them received ACE/ARB. Even as the number of indications increased to four or more, the report indicates that the maximum prevalence ACE/ARB use was only 53 percent.

"Renin-angiotensin system blockade in individuals with diabetes is associated with decreases in cardiovascular events and renal failure," the author concludes. "Despite guideline indications, it appears that neither albuminuria nor cardiovascular disease are prompting increased rates of ACE/ARB use. To further increase ACE/ARB use and improve cardiovascular outcomes, it may be desirable to create a measure of ACE/ARB use for all older individuals with diabetes for inclusion in future diabetes performance measurement sets."

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