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Lowering Blood Pressure Reduces Renal Events in Type 2 Diabetes
,
Toshiharu Ninomiya,
Avinesh Pillai,
Anushka Patel,
Alan Cass ,
Bruce Neal,
Neil Poulter,
Stephen Harrap,
Carl-Erik Mogensen,
Mark Cooper,
Michel Marre,
Bryan Williams ,
Pavel Hamet
and other authors.
Abstract
BP is an important determinant of kidney disease among patients with diabetes. The recommended thresholds to initiate treatment to lower BP are 130/80 and 125/75 mmHg for people with diabetes and nephropathy, respectively. We sought to determine the effects of lowering BP below these currently recommended thresholds on renal outcomes among 11,140 patients who had type 2 diabetes and participated in the Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation (ADVANCE) study. Patients were randomly assigned to fixed combination perindopril-indapamide or placebo, regardless of their BP at entry. During a mean follow-up of 4.3 yr, active treatment reduced the risk for renal events by 21% (P