Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Combination Drug Therapy To Lower Blood Pressure Could Reduce Cardiovascular Outcomes For People With Type 2 Diabetes

Results of the ADVANCE* study published online by THE LANCET suggest that drug therapy with an ACE inhibitor and diuretic to lower blood pressure could reduce cardiovascular outcomes and risk of death for people with type 2 diabetes, regardless of baseline blood pressure values. The online publication of the study coincides with presentation of the findings at the European Society of Cardiology meeting in Vienna on Sunday Sept 2, 2007**.

By 2030, an estimated 350 million people will be living with diabetes worldwide. Individuals with type 2 diabetes are at an increased risk of cardiovascular outcomes including heart attack, stroke, and microvascular outcomes such as degenerative eye disease. Current guidelines recommend the lowering of blood pressure for people with type 2 diabetes to reduce the risk of such events, though a strategy to reduce blood pressure regardless of baseline blood pressure (ie, including people with diabetes who do not have raised blood pressure) has not been proven in randomised trials to date.

The ADVANCE trial recruited around 11000 individuals with type 2 diabetes from 215 medical centres in 20 countries across the world. Individuals were randomised to receive either a combination of the ACE inhibitor perindopril and the diuretic indapamide or placebo and were followed up for over four years.

Individuals given active therapy had an average reduction in systolic blood pressure of 5•6 mm Hg and diastolic blood pressure of 2•2 mm Hg compared with the placebo group. The relative risk of a major macrovascular or microvascular event was reduced by 9% (15•5% active vs 16•8% placebo). The separate reductions in macrovascular and microvascular events were similar but were not statistically significant by themselves.

The relative risk of death from cardiovascular disease was reduced by 18% (3•8% active vs 4•6% placebo), and death from any cause was reduced by 14% (7•3% active vs 8•5% placebo). The results were not dependent on baseline blood pressure or whether individuals were using other treatments for diabetes.

One of the authors, John Chalmers (The George Institute, University of Sydney, Australia), comments: “In summary, the results of ADVANCE indicate that the routine administration of a fixed combination of perindopril and indapamide to a broad range of patients with diabetes reduces the risks of death and major macrovascular or microvascular complications, irrespective of initial blood pressure level or ancillary treatment with the many other preventive treatments typically provided to diabetic patients today. The study treatment was well tolerated, needed little monitoring or titration and is, therefore, suitable for use in a wide range of clinical circumstances worldwide. If the benefits seen in ADVANCE were applied to just half the population with diabetes worldwide, more than a million deaths would be avoided over 5 years. For these reasons, there is now a case for considering such treatment routinely for patients with type 2 diabetes.”

In an accompanying Comment, Norman M Kaplan (University of Texas Southwestern Medical Center, USA) cautions against over-interpretation of ADVANCE. He concludes: “The fixed combination of perindopril and indapamide could be the best possible protector against hypertension-related consequences for patients with type 2 diabetes, but I believe that other drugs—if they lower blood pressure as much and do not have metabolic side-effects—would be as protective as this combination treatment. As has been said many times by many experts: in most circumstances, lowering the blood pressure is what counts, not the way by which it is lowered.”

Tony Kirby | alfa
Further information:

More articles from Health and Medicine:

nachricht Advanced analysis of brain structure shape may track progression to Alzheimer's disease
26.10.2016 | Massachusetts General Hospital

nachricht Indian roadside refuse fires produce toxic rainbow
26.10.2016 | Duke University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Etching Microstructures with Lasers

Ultrafast lasers have introduced new possibilities in engraving ultrafine structures, and scientists are now also investigating how to use them to etch microstructures into thin glass. There are possible applications in analytics (lab on a chip) and especially in electronics and the consumer sector, where great interest has been shown.

This new method was born of a surprising phenomenon: irradiating glass in a particular way with an ultrafast laser has the effect of making the glass up to a...

Im Focus: Light-driven atomic rotations excite magnetic waves

Terahertz excitation of selected crystal vibrations leads to an effective magnetic field that drives coherent spin motion

Controlling functional properties by light is one of the grand goals in modern condensed matter physics and materials science. A new study now demonstrates how...

Im Focus: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

Greater Range and Longer Lifetime

26.10.2016 | Power and Electrical Engineering

VDI presents International Bionic Award of the Schauenburg Foundation

26.10.2016 | Awards Funding

3-D-printed magnets

26.10.2016 | Power and Electrical Engineering

More VideoLinks >>>