Blood Pressure Drug Combo Helps Diabetic Hearts
Large, long-term global study shows diuretic plus ACE inhibitor
reduced risk of dying from heart disease
(SOURCE: The Lancet, news release, Sept. 2, 2007)
SUNDAY, Sept. 2 (HealthDay News) -- Using a combination of
diuretics and ACE inhibitors to manage blood pressure in people with
type 2 diabetes can help protect against heart disease, according to
new data released Sunday.
The combined therapy, administered as part of a worldwide study
known as ADVANCE, reduced the risk of dying from heart disease by 18
percent.
"If the benefits seen in ADVANCE were applied to just half the
population with diabetes worldwide, more than a million deaths would be
avoided over five years. For these reasons, there is now a case for
considering such treatment routinely for patients with type 2
diabetes," study author John Chalmers, from The George Institute at the
University of Sydney in Australia, said in a prepared statement.
By 2030, an estimated 350 million people will be living with
diabetes worldwide. Heart disease kills two out of three people with
diabetes, who are at increased risk of stroke, heart attacks and
related conditions such as degenerative eye disease. Blood pressure
management is recommended to reduce the risk of heart disease.
The new findings comes from the ADVANCE trial, which tracked more
than 11,100 people with type 2 diabetes from 215 medical centers in 20
countries for four years.
The participants, all 55 or older, received either a combination of
the ACE inhibitor perindopril and the diuretic indapamide or a placebo.
Over the course of the four years, the researchers found that people
with the combined therapy had an average reduction in systolic blood
pressure of 5-6 mm Hg and diastolic blood pressure of 2 mm Hg compared
with the placebo group.
People who got the combined therapy were 9 percent less likely to
have a heart disease event, such as stroke or heart attack, over the
treatment period. They were also 18 percent less likely to die from
heart disease and 14 percent less likely to die from any cause.
The researchers noted that the impact of the combined therapy
occurred regardless of the participants'' blood pressure at the
beginning of the study.
The study was released online Sunday by The Lancet to coincide with a presentation of the research at the European Society of Cardiology meeting in Vienna.
In an accompanying commentary in the journal, Dr. Norman Kaplan, a
hypertension expert from the University of Texas Southwestern Medical
Center at Dallas, had a caution on the findings.
"The fixed combination of perindopril and indapamide could be the
best possible protector against hyper-tension-related consequences for
patients with type 2 diabetes, but I believe that other drugs, if they
lower blood pressure as much and do not have metabolic side-effects,
would be as protective as this combination treatment," he said.
And he added, "As has been said many times before by many experts:
In most circumstances, lowering the blood pressure is what counts, not
the way by which it is lowered."
More information
To learn more about diabetes and heart disease, visit the American Diabetes Association.
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