Blood pressure treatment persists for years - new findings

Australian researchers have discovered that the reductions in heart events and death, from using blood pressure-lowering drugs in patients with type 2 diabetes, persist for many years after treatment has stopped.

The global study has found that, six years after stopping intensive treatment with the combination of perindopril and indapamide, patients with type 2 diabetes continued to have a lower risk of serious heart disease and death.

The study, titled ADVANCE-ON, was led by The George Institute for Global Health and held in 20 countries. It followed up more than 80 per cent of the 11,000 patients with diabetes who had been involved in the original ADVANCE trial that started in 2001 and finished in 2007.

In ADVANCE, patients whose blood pressure had been treated with ACE inhibitor-diuretic combination for nearly five years were found to have a reduced risk of death and heart events. In the follow-up ADVANCE-ON study, these benefits were still evident six years later, but reduced compared to those during active treatment.

Speaking at the European Cardiology Society Congress in Barcelona, Principal Investigator Professor John Chalmers, of The George Institute for Global Health and The University of Sydney, said: “The findings highlight the importance of active blood pressure lowering therapy for patients with type 2 diabetes. The good news is that the benefits last longer than the treatment. The even more important news is that active treatment is needed in both the short and the long term, in order to maximise the number of lives saved.”

Study Director Associate Professor Sophia Zoungas added: “This is a completely new finding for patients with type 2 diabetes, although it has previously been noted for patients with hypertension.”

Professor Chalmers said the intensive treatment based on perindopril and indapamide was likely to have produced long lasting structural changes in the patient’s cardiovascular system.

Worldwide, it is estimated that 382 million people have diabetes and about 90 per cent of those have type 2 diabetes. Diabetes causes heart disease, blindness, kidney failure, limb amputation and stroke and is one of the top ten causes of death.

ADVANCE was funded by Australia’s National Health and Medical Research Council (NHMRC), the British Heart Foundation, Diabetes UK, and Servier.