ACEI/ARB underused in patients with type 2 diabetes in Chinese population (CCMR-3B study)

Abstract

Objective: In patients with diabetic kidney disease, it is well documented that RAS blockade is associated with an improved outcome. This observational, multicenter study examined the " realworld" use of ACEI/ARB in patients with type 2 diabetes (T2DM) in China. Method: Data from the China Cardiometabolic Registries on blood pressure, blood lipid and blood glucose in Chinese T2DM patients (CCMR-3B) were used for the present study. Consecutive outpatients with T2DM for more than 6 months were recruited to this non-interventional, observational, cross-sectional study. Albuminuria was defined as urine albumin creatinine ratio (ACR) ≤ 30mg/g. Results: A total of 25,454 outpatients with T2DMfrom6 regions in China were enrolled, 47.0%were male, and 59.8%had hypertension. ACR was measured in 6,383 of these patients and 3,231 of them ≤ 30mg/L. Among patients with hypertension, 73.0%were on antihypertensives, and 39.7%used ACEI/ARB. Of the 2,157 patients with hypertension and albuminuria, only 48.3% used ACEI/ARB. Among the non-hypertensive patients with albuminuria, ACEI/ARB usage was < 1%. Multivariate analysis revealed that comorbidities, region, hospital tier, physician specialty and patient's educational level were associated with ACEI/ARB use. Conclusion: In T2DM with hypertension and albuminuria in China, more than half of them were not treated with ACEI/ARB. This real world evidence suggests that the current treatment for patients with diabetes coexisting with hypertension and albuminuria in China is sub-optimal.