Protection of patients with diabetes, with or without hypertension: implications of ADVANCE for clinical practice. Journal of hypertension [J Hypertens] Journal article | | Title | Protection of patients with diabetes, with or without hypertension: implications of ADVANCE for clinical practice. | | Author(s) | Mancia G, Grassi G | | Institution | Clinica Medica, Department of Medicine and Prevention, San Gerardo Hospital, University of Milan-Bicocca, Monza, Milan, Italy. giuseppe.mancia@unimib.it | | Source | J Hypertens 2009 May.:S19-23. | | Abstract | Difficulties in achieving a reduction in morbidity and mortality in patients with diabetes are a result of the complexity of the disease and its intertwined relationship with hypertension and renal impairment. In the recently published Action in Diabetes and Vascular disease: PreterAx and DiamicroN-MR Controlled Evaluation (ADVANCE) trial, treatment of patients with diabetes with the fixed combination perindopril/indapamide on top of background treatments provided clinically and statistically significant reductions in blood pressure (from 145/81 to 136/73 mmHg), all-cause mortality (-14%), cardiovascular mortality (-18%), major cardiovascular events (-9%), renal events (-21%) and new-onset microalbuminuria (-21%) when compared with placebo. As the ADVANCE trial included both hypertensive and normotensive patients, its results suggest that systematically treating all patients with diabetes with perindopril/indapamide, independently of their baseline blood pressure, may have significant long-term value that can be explained partly by the reversal of end-organ damage to the kidney and the heart. Considering that patients with both hypertension and diabetes are characterized by generalized macro- and microvascular disease, the results of the ADVANCE trial, taken together with results of other perindopril/indapamide hypertension studies, support a broad use of perindopril/indapamide treatment for the long-term improvement of prognosis in hypertensive patients as well as in patients with diabetes. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 19483504 |
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