Dr. Sydney Smith
Presenter report: Mac Mahon, Stephen (Australia)
The ADVANCE (Action in Diabetes and Vascular Disease) study is largest-ever study of treatments for the prevention of compications of diabetes. Results released today show that a fixed combination of two blood pressure lowering drugs reduces the risk of death, as well as the risks of heart and kidney disease.
A total of 11 140 patients with diabetes from 20 countries world wide participated in the 4.3 year project. ADVANCE study participants were already receiving most of the usual treatments provided to patients with diabetes including other drugs to lower their blood pressure. Half received daily treatment with a single tablet containing fixed combination of two blood pressure lowering drugs (perindopril and indapamide) and half received matching inactive placebo. Those that received the study treatment experienced an 18% reduction in the risk of death from cardiovascular disease. In absolute terms, one death would be avoided among every 79 patients treated for 5 years. Additionally, the risk of coronary heart disease events was reduced by 14% and the risk of new or worsening kidney disease was reduced by 21%.
These results provide new evidence relevant to decisions about the care of 250 million people with diabetes worldwide. Most people with this condition will be killed or disabled by it. ADVANCE has shown that a simple well tolerated blood pressure lowering proram can prevent some of the most serious complications of diabetes.
Discussant : Smith, Sydney C (United States of America)
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