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 (S14%), cardiovascular mortality (S18%), major cardiovascular events (S9%), renal events (S21%) and new-onset microalbuminuria (S21%) 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 longterm 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. © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Mancia, G., & Grassi, G. (2009). Protection of patients with diabetes, with or without hypertension: implications of ADVANCE for clinical practice. JOURNAL OF HYPERTENSION, 27(Suppl. 1), S19-S23 [10.1097/01.hjh.0000354420.23557.e2].
|Citazione:||Mancia, G., & Grassi, G. (2009). Protection of patients with diabetes, with or without hypertension: implications of ADVANCE for clinical practice. JOURNAL OF HYPERTENSION, 27(Suppl. 1), S19-S23 [10.1097/01.hjh.0000354420.23557.e2].|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Titolo:||Protection of patients with diabetes, with or without hypertension: implications of ADVANCE for clinical practice|
|Autori:||Mancia, G; Grassi, G|
|Data di pubblicazione:||2009|
|Rivista:||JOURNAL OF HYPERTENSION|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1097/01.hjh.0000354420.23557.e2|
|Appare nelle tipologie:||01 - Articolo su rivista|