Blood pressure drugs cut death rate in diabetes

Blood pressure drugs
New Delhi, Sept.3: 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 Congress of Cardiology in Vienna.

One of the study leaders, Professor Stephen MacMahon from The George Institute for International Health, which will soon launch an office in Hyderabad India, 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."

Approximately 250 million people are living with diabetes across the world, most of whom will eventually be killed or disabled by the complications of their condition. 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. Previous research published by The George Institute has shown that almost three quarters of India's population is set for an epidemic of diabetes.

In a large-scale survey of rural India, 13 percent of adults aged 30 or above were found to have diabetes in a developing area of Andhra Pradesh with a further 16 percent exhibiting features of pre-diabetes. The escalating problem of diabetes in urban India is also well documented.

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.

Professor Nikhil Tandon from the All India Institute of Medical Sciences played a key role in the investigation, and said today, "The ADVANCE study is the largest clinical trial ever performed in patients with type 2 diabetes, with over 11,000 patients worldwide, and will provide important information for India about the effects of blood pressure lowering, in a broad cross-section of high-risk individuals with type 2 diabetes. This is important as India is estimated to have 30-35 million persons with diabetes."

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 percent. 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 percent and the risk of new or worsening kidney disease was reduced by 21 percent.

Senior Director of The George Institute India, Professor Lalit Dandona, noted that, "The research program at the George Institute India aims to contribute to the control of major diseases and injury in India, including diabetes and cardiovascular disease. Our goal is to help identify practical new ways of addressing these serious health problems."

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."

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 PreteraxT ,PredoniumT, 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.