Use of angiotensin-converting enzyme (ACE) inhibitors as first-line antihypertensives in patients with diabetes mellitus is supported by data from a new meta-analysis. Compared with placebo, ACE inhibitors significantly reduced doubling of serum creatinine levels and β-blockers significantly increased mortality in these patients (n = 36,917). Angiotensin-receptor blockers, calcium channel blockers, diuretics and combination therapies had no significant effects on these outcomes and none of the therapies had a significant effect on dialysis requirement in the study participants.