Combination blood pressure lowering therapy in patients with type 2 diabetes: messages from the ADVANCE trial.

IF 3.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Journal of Hypertension Pub Date : 2024-12-01 Epub Date: 2024-10-08 DOI:10.1097/HJH.0000000000003855
Nelson Wang, John Chalmers, Katie Harris, Neil Poulter, Giuseppe Mancia, Stephen Harrap, Pavel Hamet, Diederick E Grobbee, Michel Marre, Mark Woodward
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Abstract

The Action in Diabetes and Vascular disease: preterAx and diamicroN Controlled Evaluation (ADVANCE) trial investigated the effects of intensive blood pressure (BP) lowering using a fixed combination of perindopril-indapamide versus placebo in type 2 diabetes (T2D). The study showed that combination perindopril-indapamide had significant benefits in reducing cardiovascular, renal, and mortality events, with consistent relative risk reductions across different patient subgroups. Secondary analyses of ADVANCE have identified novel risk markers in T2D including cessation of BP lowering therapy, absent peripheral pulses and cardiac biomarkers to name a few. ADVANCE also shed light on practical aspects of hypertension management, including the limitations of office BP, tolerability of combination BP lowering therapy across the range of BP levels and the interpretation of changes in serum creatinine after treatment initiation. This review article summarizes the findings of ADVANCE and its subsequent substudies, which have been foundational in our understanding of BP management and the use of combination BP lowering therapy in T2D.

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2 型糖尿病患者的联合降压疗法:来自 ADVANCE 试验的信息。
糖尿病和血管疾病行动:前列腺素和二甲双胍对照评估(ADVANCE)试验研究了在 2 型糖尿病(T2D)患者中使用培哚普利-吲达帕胺固定组合与安慰剂进行强化降压的效果。研究显示,培哚普利-吲达帕胺联合用药在减少心血管、肾脏和死亡事件方面有显著疗效,不同患者亚组的相对风险降低率一致。ADVANCE 的二次分析发现了 T2D 的新型风险标记,包括停止降压治疗、外周搏动消失和心脏生物标记物等。ADVANCE 还揭示了高血压管理的实际问题,包括诊室血压的局限性、在不同血压水平下联合降压疗法的耐受性以及治疗开始后血清肌酐变化的解释。本综述文章总结了 ADVANCE 及其后续子研究的发现,这些发现对我们了解 T2D 患者的血压管理和联合降压疗法的使用具有奠基性意义。
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来源期刊
Journal of Hypertension
Journal of Hypertension 医学-外周血管病
CiteScore
7.90
自引率
6.10%
发文量
1389
审稿时长
3 months
期刊介绍: The Journal of Hypertension publishes papers reporting original clinical and experimental research which are of a high standard and which contribute to the advancement of knowledge in the field of hypertension. The Journal publishes full papers, reviews or editorials (normally by invitation), and correspondence.
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