• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

Long-term mortality benefit of BP lowering in type 2 diabetes [ADVANCE-ON trial]

byMatthew Sibbald, MD, PhD
October 13, 2014
in Cardiology, Chronic Disease, Endocrinology
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. The mortality benefit of blood pressure (BP) lowering therapy observed in the ADVANCE trial persisted at 6-year post-trial follow-up.

2. Intensive glucose control showed no benefit in reducing overall mortality or major macrovascular events compared to standard glucose control.

Evidence Rating Level: 2 (Good)

Study Rundown: The Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial was a multicentre, randomized controlled study that included over 10,000 patients with type 2 diabetes. The 2-by-2 factorial trial assessed the benefit of BP-lowering therapy compared to placebo, and intensive glucose control compared to standard glucose control to important clinical outcomes in this group. One of the main findings was that BP-lowering with combined perindopril and indapamide was associated with a reduction in overall mortality and death from cardiovascular causes. Results of the trial also showed that intensive glucose control, defined as a glycated hemoglobin level less than 6.5%, did not in-crease mortality and reduced the incidence of combined major macrovascular and microvascular events, primarily due to a reduction in the incidence of nephropathy.

The ADVANCE observational study (ADVANCE-ON) is a post-trial follow-up of surviving partici-pants from the ADVANCE trial for a median of 5.9 years. Main findings from the post-trial follow-up include that the mortality benefit of BP-lowering therapy remained significant though attenuat-ed at six years post-trial and there was no long-term benefit of intensive glucose control on overall mortality or major macrovascular events when compared to standard glucose control. This study contributes to our understanding of long-term clinical outcomes of therapy in patients with type 2 diabetes. Limitations include incomplete follow-up of the original trial participants and less stringent post-trial follow-up procedures (often by telephone or questionnaires).

Click to read the study in NEJM

Relevant Reading: Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes melli-tus (the ADVANCE trial): a randomised controlled trial

RELATED REPORTS

2 Minute Medicine Rewind February 6, 2023

Sodium-glucose cotransporter 2 inhibitors may reduce incidence of obstructive airway disease

Metformin use in Type 2 Diabetes associated with decreased risk of joint replacement

In-Depth [observational study]: This post-trial follow-up observational study included 8,494 pa-tients of 11,140 participants from the original trial. The primary outcomes measured were all-cause mortality and major macrovascular events (composite of nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular cause). The median in-trial and post-trial follow-up periods were 4.4 years and 5.9 years, respectively, for the BP-lowering comparison and 5.0 years and 5.4 years, respectively, for the glucose control comparison.

During the randomized ADVANCE trial, there was a significant between-group difference in blood pressure between the group receiving combined perindopril-indapamide and the placebo group. This difference was no longer evident 6 months after the trial and blood pressure levels were similar between the two groups during the post-trial period. The reduction in all-cause mortality observed in the perindopril-indapamide group during the trial remained significant but attenuated in the post-trial follow-up (hazard ratio, 0.91; 95% CI, 0.84 to 0.99; P=0.03). The significant be-tween-group difference in glycated haemoglobin levels observed in the randomized trial was no longer evident at the first post-trial visit and levels remained similar throughout the post-trial peri-od. There was no benefit observed with intensive glucose control on all-cause mortality or major macrovascular events compared to standard glucose control.

Image: PD

©2012-2014 2minutemedicine.com. All rights reserved. No works may be reproduced without ex-pressed written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT.

Tags: blood pressurediabetes
Previous Post

Novel nerve autograft method may aid facial paralysis recovery

Next Post

Salvage surgery may improve survival in local recurrence of esophageal cancer

RelatedReports

Prevalence of hypertension among adolescents varies by race and BMI
Weekly Rewinds

2 Minute Medicine Rewind February 6, 2023

February 6, 2023
CPAP may not decrease cardiovascular events in sleep apnea
Endocrinology

Sodium-glucose cotransporter 2 inhibitors may reduce incidence of obstructive airway disease

February 2, 2023
Type 2 diabetes associated with reduction in disability-free life years
Chronic Disease

Metformin use in Type 2 Diabetes associated with decreased risk of joint replacement

January 16, 2023
Pediatric DKA associated with recent acute care visits
Cardiology

Low-carbohydrate, high-fat diet improves glycemic control in type 2 diabetic patients

January 11, 2023
Next Post
Salvage surgery may improve survival in local recurrence of esophageal cancer

Salvage surgery may improve survival in local recurrence of esophageal cancer

Afamelanotide plus UV-B phototherapy effective for vitiligo

Afamelanotide plus UV-B phototherapy effective for vitiligo

Preterm birth associated with elevated plasma insulin levels

Hidradenitis suppurativa linked with metabolic syndrome

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Former professional football players may be at greater risk of chronic disease
  • Low-dose pirfenidone may be noninferior to standard dosing in patients with idiopathic pulmonary fibrosis
  • Protein-truncating variants in apolipoprotein B and PCSK9 genes associated with lower exposure to atherogenic LDL cholesterol and risk of coronary heart disease
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options