Which Antihypertensive Drugs Are Best for Patients with Type 2 Diabetes and Hypertension?

Placebo-controlled trials have shown that renin-angiotensin system (RAS) blockers (i.e., angiotensin-converting–enzyme inhibitors and angiotensin-receptor blockers) prevent adverse cardiovascular (CV) and renal outcomes in patients with diabetes and hypertension. As a result, the American Diabetes Association recommends RAS blockers as first-line treatment in such patients (Diabetes Care 2015; 38[Suppl 1]:S49). In this meta-analysis of 19 randomized controlled trials, researchers determined whether RAS blockers were superior to other antihypertensive drugs for preventing adverse CV and renal outcomes in >25,000 people with type 2 diabetes.

RAS blockers were compared with calcium-channel blockers in 15 trials, with thiazide diuretics in 3 tri…