Anti-hypertensive drugs cut mortality rate in diabetics

5 September, 2007:

Diabetes patients can reduce the risk of death by 18% if they take two anti-hypertensive medications.

Diabetics have a higher risk of suffering from heart disease, stroke, and kidney disease.

A new, extensive study has revealed that, by giving anti-hypertensive drugs to diabetes patients, it is possible to reduce the mortality rate significantly.

According to the American Diabetes Association, 2 out of 3 people with diabetes die from heart disease and stroke.

While controlling blood sugar levels should be the primary aim of diabetes therapy, equal attention must be paid to the management of blood pressure
and management of cholesterol, according to the American Diabetes Association. This is because studies have shown that over 60% of people with diabetes have high blood pressure and almost all patients suffer from increased level of triglycerides, low HDL cholesterol, or high LDL cholesterol.

The new trial shows that, by giving two common blood pressure drugs in the form of diuretics and ACE inhibitors, it is possible to lower the risk of heart disease in diabetic patients.

The study, named Action in diabetes and vascular disease (ADVANCE), included 11,140 patients with diabetes from 20 countries across the world. All patients were suffering from Type 2 diabetes. The study lasted for four years.

All patients were randomly assigned to receive a fixed combination of ACE inhibitor perindopril and the diuretic indapamide or a placebo. Researchers
found that people who received a combination of the anti-hypertensive drugs had systolic blood pressure readings that were 5-6 mm Hg and diastolic blood pressure of 2 mm Hg less than those who took a placebo.

The researchers told the European Society of Cardiology meeting in Vienna, Austria, that patients receiving the combined therapy had a 9% lower risk of a heart disease and were also 18% less likely to die from heart disease. Moreover, these patients were 14% less likely to die from any cause.

The study has also been published in the medical journal The Lancet.

Professor Stephen MacMahon, from the George Institute for International Health in Australia and the lead researcher, said the results had wide-reaching implications for those suffering from Type 2 diabetes. This treatment, he explained, reduced the likelihood of dying from the complications of diabetes by almost one-fifth, with virtually no side-effects.

However, in an accompanying commentary in The Lancet, Dr Norman Kaplan, an expert on hypertension from the University of Texas Southwestern Medical Center at Dallas, the United States, was cautious about the findings. He wrote: “As has been said many times before by many experts, in most circumstances, lowering the blood pressure is what counts, not the way by which it is lowered.”