TY - JOUR
T1 - Effects of combination of perindopril, indapamide, and calcium channel blockers in patients with type 2 diabetes mellitus
T2 - Results from the action in diabetes and vascular disease: Preterax and diamicron controlled evaluation (ADVANCE) trial
AU - Chalmers, John
AU - Arima, Hisatomi
AU - Woodward, Mark
AU - Mancia, Giuseppe
AU - Poulter, Neil
AU - Hirakawa, Yoichiro
AU - Zoungas, Sophia
AU - Patel, Anushka
AU - Williams, Bryan
AU - Harrap, Stephen
PY - 2014/2
Y1 - 2014/2
N2 - The objective of the present analysis was to determine the effects of a fixed combination of perindopril and indapamide in combination with calcium channel blockers (CCBs) in patients with type 2 diabetes mellitus. The Action in Diabetes and Vascular Disease: Preterax and Diamicron Controlled Evaluation (ADVANCE) trial was a factorial randomized controlled trial. A total of 11 140 patients with type 2 diabetes mellitus were randomly assigned to fixed combination of perindopril-indapamide (4/1.25 mg) or placebo. Effects of randomized treatment on mortality and major cardiovascular outcomes were examined in subgroups defined by baseline use of CCBs. Patients on CCB at baseline (n=3427) constituted a higher risk group compared with those not on CCB (n=7713), with more extensive use of antihypertensive and other protective therapies. Active treatment reduced the relative risk of death by 28% (95% confidence interval, 10%-43%) among patients with CCB at baseline compared with 5% (-12% to 20%) among those without CCB (P homogeneity=0.02) and 14% (2%-25%) for the whole population. Similarly, the relative risk reduction for major cardiovascular events was 12% (-8% to 28%) versus 6% (-10% to 19%) for those with and without CCB at baseline although the difference was not statistically significant (P homogeneity=0.38). There was no detectable increase in adverse effects in those receiving CCB. The combination of perindopril and indapamide with CCBs seems to provide further protection against mortality in patients with type 2 diabetes mellitus.
AB - The objective of the present analysis was to determine the effects of a fixed combination of perindopril and indapamide in combination with calcium channel blockers (CCBs) in patients with type 2 diabetes mellitus. The Action in Diabetes and Vascular Disease: Preterax and Diamicron Controlled Evaluation (ADVANCE) trial was a factorial randomized controlled trial. A total of 11 140 patients with type 2 diabetes mellitus were randomly assigned to fixed combination of perindopril-indapamide (4/1.25 mg) or placebo. Effects of randomized treatment on mortality and major cardiovascular outcomes were examined in subgroups defined by baseline use of CCBs. Patients on CCB at baseline (n=3427) constituted a higher risk group compared with those not on CCB (n=7713), with more extensive use of antihypertensive and other protective therapies. Active treatment reduced the relative risk of death by 28% (95% confidence interval, 10%-43%) among patients with CCB at baseline compared with 5% (-12% to 20%) among those without CCB (P homogeneity=0.02) and 14% (2%-25%) for the whole population. Similarly, the relative risk reduction for major cardiovascular events was 12% (-8% to 28%) versus 6% (-10% to 19%) for those with and without CCB at baseline although the difference was not statistically significant (P homogeneity=0.38). There was no detectable increase in adverse effects in those receiving CCB. The combination of perindopril and indapamide with CCBs seems to provide further protection against mortality in patients with type 2 diabetes mellitus.
KW - angiotensin-converting enzyme inhibitors
KW - blood pressure
KW - calcium channel blockers
KW - combination
KW - diabetes mellitus
KW - diuretics
KW - drug therapy
KW - randomized controlled trial
UR - http://www.scopus.com/inward/record.url?scp=84892923676&partnerID=8YFLogxK
U2 - 10.1161/HYPERTENSIONAHA.113.02252
DO - 10.1161/HYPERTENSIONAHA.113.02252
M3 - Article
C2 - 24324048
AN - SCOPUS:84892923676
VL - 63
SP - 259
EP - 264
JO - Hypertension (Dallas, Tex. : 1979)
JF - Hypertension (Dallas, Tex. : 1979)
SN - 0194-911X
IS - 2
ER -