Blood pressure drugs cut death rate in diabetes

The largest-ever study of treatments for diabetes has shown 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. Results from the ADVANCE (Action in Diabetes and Vascular Disease) Study were presented today at the European Society of Cardiology Congress 2007 in Vienna.

One of the study leaders, Professor Stephen MacMahon from The George Institute for International Health in Australia, said "these results represent an important step forward in health care for the millions of people with diabetes worldwide. This treatment reduced the likelihood of dying from the complications of diabetes by almost one-fifth, with virtually no side-effects.”

Globally, there are approximately 250 million people with diabetes, most of whom will eventually be killed or disabled by the complications of their condition. The most common cause of death in people with diabetes is heart disease. Kidney disease also affects a large proportion. In 2006, the United Nations issued a statement calling for increased international action to combat the global epidemic of diabetes.

A total of 11 140 patients with diabetes from 20 countries world wide participated in the 4.3 year project. 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.

Dr. Anushka Patel, Study Director also from The George Institute, said “the participants in ADVANCE were already receiving most of the usual treatments provided to patients with diabetes, including other drugs to lower blood pressure. However, addition of the fixed combination of perindopril and indapamide reduced the risk of death from any cause by 14% and the risk of death from cardiovascular disease by 18%. In absolute terms, one death would be avoided for every 79 patients treated with the fixed combination of perindopril and indapamide for 5 years. The risk of coronary heart disease events was reduced by 14% and the risk of new or worsening kidney disease was reduced by 21%.

Professor John Chalmers, the author of previous international guidelines for the treatment of high blood pressure and chairman of the study management group, said, “the results clearly demonstrate that we have the tools to blunt the impact of the global diabetes epidemic facing rich and poor countries alike. But concerted action is urgently required to ensure that patients with diabetes are identified and provided with treatments proven to improve important outcomes like survival.”

Reference:

This study was presented at the ESC Congress 2007 in Vienna.

Notes:

The ADVANCE Study was conducted by an international group of independent medical researchers with support from Servier, the manufacturer of perindopril and indapamide, and the National Health and Medical Research Council of Australia.

Perindopril is an angiotensin converting enzyme (ACE) inhibitor and indapamide is a thiazide-like diuretic. The fixed combination of perindopril and indapamide is marketed in 97 countries worldwide under the brand names Preterax ,Predonium, Biprel, Prelectal, Noriplex or Noliprel

The study was coordinated by The George Institute at the University of Sydney. The George Institute is a renowned international medical research centre with branches in Sydney, Beijing, Hyderabad and London.

The European Society of Cardiology (ESC):

The ESC represents nearly 53,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.

The ESC achieves this through a variety of scientific and educational activities including the coordination of: clinical practice guidelines, education courses and initiatives, pan-European surveys on specific disease areas and the ESC Annual Congress, the largest medical meeting in Europe. The ESC also works closely with the European Commission and WHO to improve health policy in the EU.

The ESC comprises 3 Councils, 5 Associations, 19 Working Groups, 50 National Cardiac Societies and an ESC Fellowship Community (Fellow, FESC; Nurse Fellow, NFESC). For more information on ESC Initiatives, Congresses and Constituent Bodies.