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dc.contributor.authorZoungas, S
dc.contributor.authorde Galan, BE
dc.contributor.authorNinomiya, T
dc.contributor.authorGrobbee, D
dc.contributor.authorHamet, P
dc.contributor.authorHeller, S
dc.contributor.authorMacMahon, S
dc.contributor.authorMarre, M
dc.contributor.authorNeal, B
dc.contributor.authorPatel, A
dc.contributor.authorWoodward, M
dc.contributor.authorChalmers, J
dc.contributor.authorADVANCE Collaborative Group,
dc.contributor.authorCass, A
dc.contributor.authorGlasziou, P
dc.contributor.authorHarrap, S
dc.contributor.authorLisheng, L
dc.contributor.authorMancia, G
dc.contributor.authorPillai, A
dc.contributor.authorPoulter, N
dc.contributor.authorPerkovic, V
dc.contributor.authorTravert, F
dc.date.accessioned2020-12-18T03:54:10Z
dc.date.available2020-12-18T03:54:10Z
dc.date.issued2009-11
dc.identifierpii: dc09-0959
dc.identifier.citationZoungas, S., de Galan, B. E., Ninomiya, T., Grobbee, D., Hamet, P., Heller, S., MacMahon, S., Marre, M., Neal, B., Patel, A., Woodward, M., Chalmers, J., ADVANCE Collaborative Group, , Cass, A., Glasziou, P., Harrap, S., Lisheng, L., Mancia, G., Pillai, A. ,... Travert, F. (2009). Combined effects of routine blood pressure lowering and intensive glucose control on macrovascular and microvascular outcomes in patients with type 2 diabetes: New results from the ADVANCE trial.. Diabetes Care, 32 (11), pp.2068-2074. https://doi.org/10.2337/dc09-0959.
dc.identifier.issn0149-5992
dc.identifier.urihttp://hdl.handle.net/11343/255969
dc.description.abstractOBJECTIVE: To assess the magnitude and independence of the effects of routine blood pressure lowering and intensive glucose control on clinical outcomes in patients with long-standing type 2 diabetes. RESEARCH DESIGN AND METHODS: This was a multicenter, factorial randomized trial of perindopril-indapamide versus placebo (double-blind comparison) and intensive glucose control with a gliclazide MR-based regimen (target A1C <or=6.5%) versus standard glucose control (open comparison) in 11,140 participants with type 2 diabetes who participated in the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial. Annual event rates and risks of major macrovascular and microvascular events considered jointly and separately, renal events, and death during an average 4.3 years of follow-up were assessed, using Cox proportional hazards models. RESULTS: There was no interaction between the effects of routine blood pressure lowering and intensive glucose control for any of the prespecified clinical outcomes (all P > 0.1): the separate effects of the two interventions for the renal outcomes and death appeared to be additive on the log scale. Compared with neither intervention, combination treatment reduced the risk of new or worsening nephropathy by 33% (95% CI 12-50%, P = 0.005), new onset of macroalbuminuria by 54% (35-68%, P < 0.0001), and new onset of microalbuminuria by 26% (17-34%). Combination treatment was associated with an 18% reduction in the risk of all-cause death (1-32%, P = 0.04). CONCLUSIONS: The effects of routine blood pressure lowering and intensive glucose control were independent of one another. When combined, they produced additional reductions in clinically relevant outcomes.
dc.languageeng
dc.publisherAmerican Diabetes Association
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0
dc.titleCombined effects of routine blood pressure lowering and intensive glucose control on macrovascular and microvascular outcomes in patients with type 2 diabetes: New results from the ADVANCE trial.
dc.typeJournal Article
dc.identifier.doi10.2337/dc09-0959
melbourne.affiliation.departmentPhysiology
melbourne.source.titleDiabetes Care
melbourne.source.volume32
melbourne.source.issue11
melbourne.source.pages2068-2074
dc.rights.licenseCC BY-NC-ND
melbourne.elementsid1293686
melbourne.openaccess.pmchttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2768202
melbourne.contributor.authorHarrap, Stephen
dc.identifier.eissn1935-5548
melbourne.accessrightsOpen Access


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