Indications for and Utilization of ACE Inhibitors in Older Individuals with Diabetes
dc.contributor.author | Rosen, Allison B. | en_US |
dc.date.accessioned | 2010-06-01T21:41:16Z | |
dc.date.available | 2010-06-01T21:41:16Z | |
dc.date.issued | 2006-04 | en_US |
dc.identifier.citation | Rosen, Allison B . (2006). "Indications for and Utilization of ACE Inhibitors in Older Individuals with Diabetes." Journal of General Internal Medicine 21(4): 315-319. <http://hdl.handle.net/2027.42/74734> | en_US |
dc.identifier.issn | 0884-8734 | en_US |
dc.identifier.issn | 1525-1497 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/74734 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=16686805&dopt=citation | en_US |
dc.description.abstract | Angiotensin-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. OBJECTIVES : To 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 PARTICIPANTS : Survey of 742 individuals≥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. RESULTS : Ninety-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. CONCLUSIONS : ACE/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. | en_US |
dc.format.extent | 92629 bytes | |
dc.format.extent | 3109 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Blackwell Publishing Inc | en_US |
dc.rights | © 2006 by the Society of General Internal Medicine. All rights reserved | en_US |
dc.subject.other | Diabetes | en_US |
dc.subject.other | ACE Inhibitors | en_US |
dc.subject.other | Angiotensin Receptor Blockers | en_US |
dc.subject.other | Secondary Prevention | en_US |
dc.subject.other | Renal Disease | en_US |
dc.subject.other | Cardiovascular Disease | en_US |
dc.subject.other | Quality of Care | en_US |
dc.subject.other | Performance Measures | en_US |
dc.title | Indications for and Utilization of ACE Inhibitors in Older Individuals with Diabetes | en_US |
dc.type | Article | en_US |
dc.subject.hlbsecondlevel | Internal Medicine and Specialties | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Division of General Medicine, University of Michigan Health Systems, Ann Arbor, MI, USA ; | en_US |
dc.contributor.affiliationum | Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA ; | en_US |
dc.contributor.affiliationother | Center for Practice Management and Outcomes Research, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, MI, USA. | en_US |
dc.identifier.pmid | 16686805 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/74734/1/j.1525-1497.2006.00351.x.pdf | |
dc.identifier.doi | 10.1111/j.1525-1497.2006.00351.x | en_US |
dc.identifier.source | Journal of General Internal Medicine | en_US |
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dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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