About My Health Careers Internship MedBlogs Contact us

Blood Pressure and Blood Glucose Control Lead to Remarkable Reduction in Kidney Complications

by Gopalan on September 11, 2008 at 9:31 AM
Font : A-A+

 Blood Pressure and Blood Glucose Control Lead to Remarkable Reduction in Kidney Complications

Blood pressure and blood glucose control lead to 33 per cent reduction in serious kidney complications among patients with Type 2 diabetes.

These results from ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation) were presented at the European Association for the Study of Diabetes (EASD) in Rome Wednesday. It is considered the largest study of its kind.


Previous findings from ADVANCE have shown that tight control of blood glucose with a regimen based on gliclazide (modified release) reduces major kidney complications, while routine blood pressure lowering with the fixed combination of perindopril and indapamide significantly reduces the risk of death, as well as the risks of heart and kidney disease. This new analysis of the joint effects of these two treatments has revealed even greater protection in a multi-factorial approach to treating diabetes.

Chief investigator, Professor John Chalmers from The George Institute for International Health, Australia said, "The combination of routine blood pressure lowering and tighter glucose control in ADVANCE confers very substantial benefits with reductions of one third for serious kidney disease, one quarter for cardiovascular death and close to one fifth for death from any cause. These results provide powerful incentives for the millions of people living with type 2 diabetes."

Diabetes mellitus is one of the greatest threats to the health of populations worldwide. Globally, there are over 250 million people with diabetes and that number is estimated to rise to around 400 million in 2025. ADVANCE was initiated and designed by researchers at Australia's George Institute for International Health and involved a group of independent medical researchers from 20 countries worldwide. The study involved 11,140 patients with type 2 diabetes who were treated and followed for five years.

The new analysis confirms that the effects of the two treatments are independent of one another for all pre-specified clinical outcomes, suggesting that the separate effects of intensive glucose control and routine blood pressure lowering are fully additive.

The study was designed to determine the separate and the joint effects of routine blood pressure lowering, regardless of the starting blood pressure level, and of tighter glucose control regardless of the starting blood sugar level, on the risks of complications in patients with type 2 diabetes.

"Overall, the ADVANCE study has continued to find positive benefits for people living with type 2 diabetes across the world. Both blood pressure and blood glucose control have important roles to play in diabetes management," concluded Professor Chalmers.

ADVANCE was designed, conducted, monitored, analysed and reported by a collaborative medical research group supported by the Australian Government's National Health and Medical Research Council after full peer review.

For the blood pressure lowering comparison as published in Lancet in 2007, 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.

For this comparison, the key findings of ADVANCE were:

Reduced the risk of death from any cause by 14%

Reduced 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 five 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%.

For the blood glucose comparison, one half of the patients received an intensive glucose lowering regimen based on the sulfonylurea, modified-release gliclazide, with other drugs as required, targeting an haemogloboin A1c level of 6.5% or below, and the other half were treated according to local guidelines.

For this comparison the key findings of ADVANCE were:

Achieving the target HbA1c level of 6.5%, with safety,

Significant reductions of 10% in the overall risk of serious diabetes complications , of (21%) in kidney disease and of 30% in the development of proteinuria, a well established marker of increased cardiovascular risk.

Achieving a positive trend towards reduction in the risk of cardiovascular death (12%), although not statistically significant.

Source: Medindia

News A-Z
News Category
What's New on Medindia
Turmeric: Magic Ingredient to Keep you Healthy in Winter
Top 7 Benefits of Good Oral Hygiene
Healthy and Safer Thanksgiving 2021
View all

Medindia Newsletters Subscribe to our Free Newsletters!
Terms & Conditions and Privacy Policy.

More News on:
High Blood Pressure Thalassemia Diabetes - Self-Monitoring of Blood Glucose (SMBG) Urinary Stones In Children Vesico-Ureteric Reflux Causing UTI in Children Hydronephrosis / Antenatal Counseling Diet Lifestyle and Heart Disease Diet and High Blood Pressure Stress and the Gender Divide Kidney Disease 
Recommended Reading
Diabetes - Self-Monitoring of Blood Glucose (SMBG)
Self-Monitoring Of Blood Glucose (SMBG) is one of the greatest advancements in the management of Di...
Diet and High Blood Pressure
High blood pressure or hypertension is defined as a blood pressure of above 140 mm Hg (systolic) and...
High Blood Pressure
High blood pressure or hypertension is a chronic condition, which usually lasts a lifetime once it i...
Hydronephrosis / Antenatal Counseling
Currently most pregnant women undergo one or two ultrasound scans during their pregnancy....
Stress and the Gender Divide
Stress has become entwined in the current lifestyle of a young working couple and has resulted in th...
Thalassemia is an inherited blood disorder passed on through parental genes causing the body to prod...
Urinary Stones In Children
There is a wide misconception that only adults develop stones. On the contrary kidney stones are ver...
Vesico-Ureteric Reflux Causing UTI in Children
Bacterial infection of urinary bladder can cause pain and burning sensation while passing urine. Abn...

Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

© All Rights Reserved 1997 - 2021

This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use