A recent prospective study reported at the European Society of Cardiology 2013 (ESC2013) showed no significant difference in the effect of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) therapy on the cumulative incidence of new-onset diabetes in a consecutively enrolled Asian population of patients with cardiovascular disease. Angiotensin II has been shown to increase hepatic glucose production and decrease insulin sensitivity. Angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) have been widely used to control hypertension and are associated with a reduced incidence of new-onset diabetes mellitus (DM). However, in Asian populations, there are limited data on whether ACEI and ARB have different effects on new-onset diabetes. A total of 1,856 patients without DM (PTS) were enrolled in the study from January 2004 to September 2009. To correct for potential confounders, propensity score matching (PSM) analysis was performed using a logistic regression model. The primary endpoint was the cumulative incidence of new-onset diabetes mellitus, which was defined as fasting glucose ≥126 mg/dL or HbA1c ≥6.5%. In addition, multivariate Cox regression analysis of the above variables was used to determine the differential effect of ACEI versus ARB on new-onset diabetes. The results showed that the mean follow-up time was 963 ± 293 days for all PT groups and 970 ± 288 days for the PSM group. After performing PSM (C-statistic = 0.728), a total of 642 baseline-corrected patients (ACEI group = 321, control group = 321) were selected for analysis. Multivariate analysis and Kaplan-Meyer curves obtained by PSM showed no significant difference in the cumulative incidence of new-onset diabetes between the ACEI and ARB groups (P = 0.145, Figure 1).