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[2型糖尿病中高血压相关损害的预防:ADVANCE试验的第一步]

[The prevention of the hypertension related damage in type-2 diabetes: the first step of the ADVANCE trial].

作者信息

Nagy Viktor

机构信息

Semmelweis Egyetem, Altalános Orvostudományi Kar, II. Belgyógyászati Klinika, Budapest.

出版信息

Orv Hetil. 2008 Jan 6;149(1):19-22. doi: 10.1556/OH.2008.28275.

Abstract

ADVANCE (Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation) is a large-scale trial designed to investigate the benefits of blood pressure lowering and intensive glucose control in patients with type 2 diabetes. After a mean of 4.3 years of follow-up, 73% of those assigned to active treatment (fix combination of 4/1.25 mg perindopril/indapamide) and 74% of those assigned to control remained on randomised treatment. Compared with patients assigned to placebo, those assigned to active therapy had a mean reduction in blood pressure of 5.6/2.2 mm Hg. The relative risk of a major macrovascular or microvascular event was reduced by 9% (861 [15.5%] active vs 938 [16.8%] placebo; hazard ratio 0.91, 95% CI 0.83-1.00, p = 0.04). The fix combination of perindopril and indapamide could be the best possible protector against hypertension-related consequences for patients with type 2 diabetes mellitus.

摘要

ADVANCE(糖尿病与血管疾病行动:培哚普利吲达帕胺片和微量血糖仪对照评估)是一项大规模试验,旨在研究2型糖尿病患者降低血压和强化血糖控制的益处。经过平均4.3年的随访,分配至积极治疗组(4/1.25毫克培哚普利/吲达帕胺固定复方制剂)的患者中有73%、分配至对照组的患者中有74%仍接受随机分组治疗。与分配至安慰剂组的患者相比,分配至积极治疗组的患者平均血压降低了5.6/2.2毫米汞柱。主要大血管或微血管事件的相对风险降低了9%(积极治疗组861例[15.5%],安慰剂组938例[16.8%];风险比0.91,95%可信区间0.83 - 1.00,p = 0.04)。培哚普利和吲达帕胺的固定复方制剂可能是2型糖尿病患者预防高血压相关后果的最佳保护措施。

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