[The prevention of the hypertension related damage in type-2 diabetes: the first step of the ADVANCE trial]

Abstract

ADVANCE (Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation) is a large-scale trial designed to investigate the benefits of blood pressure lowering and intensive glucose control in patients with type 2 diabetes. After a mean of 4.3 years of follow-up, 73% of those assigned to active treatment (fix combination of 4/1.25 mg perindopril/indapamide) and 74% of those assigned to control remained on randomised treatment. Compared with patients assigned to placebo, those assigned to active therapy had a mean reduction in blood pressure of 5.6/2.2 mm Hg. The relative risk of a major macrovascular or microvascular event was reduced by 9% (861 [15.5%] active vs 938 [16.8%] placebo; hazard ratio 0.91, 95% CI 0.83-1.00, p = 0.04). The fix combination of perindopril and indapamide could be the best possible protector against hypertension-related consequences for patients with type 2 diabetes mellitus.