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The ADVANCE trial: further PROGRESS with HOPE

Journal of Human Hypertension volume 21, pages 911–913 (2007)Cite this article

The coexistence of hypertension and type II diabetes mellitus is recognized as a major factor in the development of cardiovascular disease.1, 2, 3 There are many mediators of this amplification of atherosclerosis including the renin–angiotensin–aldosterone system, abnormalities of extracellular matrix turnover, endothelial damage/dysfunction, vascular inflammation, insulin resistance, platelet activation and changes in the coagulation cascade leading to a pro-thrombotic state.4, 5, 6 It is accepted that aggressive blood pressure reduction in patients with diabetes and hypertension has important benefits on a range of surrogate clinical end points7, 8, 9 and confers protection against both macro- and microvascular diseases.10, 11 Benefits are seen regardless of the class of anti-hypertensive therapy used.

The recent publication of the Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation (ADVANCE) trial12 extends these data in diabetes. This randomized controlled trial in 11 140 patients with diabetes (the largest clinical treatment trial in diabetes so far) tested both the impact of blood pressure lowering and possible additional cardiovascular protection—if any—attributable to intensive glucose lowering. There were no blood pressure eligibility criteria.

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References

  1. Czupryniak L, Saryusz-Wolska M, Pawlowski M, Loba J . Elevated systolic blood pressure is present in almost all individuals with newly diagnosed diabetes. J Hum Hypertens 2006; 20 (3): 231–233.

    Article  CAS  Google Scholar 

  2. Kamadjeu RM, Edwards R, Atanga JS, Unwin N, Kiawi EC, Mbanya JC . Prevalence, awareness and management of hypertension in Cameroon: findings of the 2003 Cameroon Burden of Diabetes Baseline Survey. J Hum Hypertens 2006; 20 (1): 91–92.

    Article  CAS  Google Scholar 

  3. Jafar TH . Blood pressure, diabetes, and increased dietary salt associated with stroke—results from a community-based study in Pakistan. J Hum Hypertens 2006; 20 (1): 83–85.

    Article  CAS  Google Scholar 

  4. Karalliedde J, Viberti G . Evidence for renoprotection by blockade of the renin–angiotensin–aldosterone system in hypertension and diabetes. J Hum Hypertens 2006; 20 (4): 239–253.

    Article  CAS  Google Scholar 

  5. Lin YH, Chiu YW, Shiau YC, Yen RF, Tsai IJ, Ho YL et al. The relation between serum level of aminoterminal propeptide of type I procollagen and diastolic dysfunction in hypertensive patients without diabetes mellitus: a pilot study. J Hum Hypertens 2006; 20 (12): 964–967.

    Article  CAS  Google Scholar 

  6. Stefanski A, Majkowska L, Ciechanowicz A, Frankow M, Safranow K, Parczewski M et al. Association between the Pro12Ala variant of the peroxisome proliferator-activated receptor-gamma2 gene and increased 24-h diastolic blood pressure in obese patients with type II diabetes. J Hum Hypertens 2006; 20 (9): 684–692.

    Article  CAS  Google Scholar 

  7. Spoelstra-de Man AM, van Ittersum FJ, Schram MT, Kamp O, van Dijk RA, Ijzerman RG et al. Aggressive antihypertensive strategies based on hydrochlorothiazide, candesartan or lisinopril decrease left ventricular mass and improve arterial compliance in patients with type II diabetes mellitus and hypertension. J Hum Hypertens 2006; 20 (8): 599–611.

    Article  CAS  Google Scholar 

  8. Kuch B, von Scheidt W, Peter W, Heier M, Wichmann HE, Meisinger C . Influence of antihypertensive therapy and blood pressure control on left ventricular geometry and function in subjects with type II diabetes: the Augsburg Diabetes Family Study. J Hum Hypertens 2006; 20 (10): 757–764.

    Article  CAS  Google Scholar 

  9. Varughese GI, Lip GY . Hypertension in patients with type-II diabetes: relation to urinary albumin excretion, endothelial function and inflammation. J Hum Hypertens 2005; 19 (6): 421–424.

    Article  CAS  Google Scholar 

  10. Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of different blood pressure-lowering regimens on major cardiovascular events in individuals with and without diabetes mellitus. Arch Intern Med 2005; 165 (12): 1410–1419.

    Article  Google Scholar 

  11. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ 1998; 317 (7160): 703–713.

    Article  Google Scholar 

  12. Patel A, ADVANCE Collaborative Group, MacMahon S, Chalmers J, Neal B, Woodward M et al. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet 2007; 370 (9590): 829–840.

    Article  CAS  Google Scholar 

  13. Heart Outcomes Prevention Evaluation (HOPE) Study Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE sub study. Lancet 2000; 355: 253–258.

    Article  Google Scholar 

  14. PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. Lancet 2001; 358 (9287): 1033–1041.

    Article  Google Scholar 

  15. Kakar P, Lip GY . Towards understanding the aetiology and pathophysiology of human hypertension: where are we now? J Hum Hypertens 2006; 20 (11): 833–836.

    Article  CAS  Google Scholar 

  16. Varughese GI, Patel JV, Lip GY . Blood pressure control in the setting of diabetes mellitus: new targets, new hope for improvement? J Hum Hypertens 2006; 20 (9): 635–637.

    Article  CAS  Google Scholar 

  17. MacFadyen RJ . Intraindividual temporal variance of biomarkers and the definition of individualized prognosis in cardiovascular patients. J Hum Hypertens 2006; 20: 383–386.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. University Department of Medicine, City Hospital, Birmingham, UK,

    V J Karthikeyan & R J MacFadyen

  2. Hypertensive Diseases Unit, Section of Endocrinology, Diabetes and Metabolism, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA

    G Bakris

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  1. V J Karthikeyan
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  2. G Bakris
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  3. R J MacFadyen
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Correspondence to R J MacFadyen.

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Karthikeyan, V., Bakris, G. & MacFadyen, R. The ADVANCE trial: further PROGRESS with HOPE. J Hum Hypertens 21, 911–913 (2007). https://doi.org/10.1038/sj.jhh.1002300

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