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Combined blood pressure therapy cuts risk of cardiovascular events

By Lilian Anekwe

The fixed dose combination of perindopril plus indapamide is effective at reducing cardiovascular and renal outcomes in patients with type 2 diabetes across all CKD severities, say Australian researchers.

Australian researchers tested the effects of treatment with perindopril 4mg and indapamide 1.25 mg daily versus placebo in 10,640 individuals with Type 2 diabetes at increased CV risk.

After a mean of 4.3 years of follow-up, perindopril/indapamide treatment versus placebo reduced average systolic and diastolic blood pressure in the corresponding groups by 6.1/2.4mm Hg in all patients with CKD, but by 5.3/2.1mm Hg in patients with CKD stage 1 or 2, and 4.5/1.8 mmHg in patients with stage 3 or worse.

Relative reductions in risk for CV death, myocardial infarction, stroke or renal events ranged from 2–18%.

However, when patients with CKD stage 3 or above were compared with those who had no CKD at baseline, the absolute treatment effect of perindopril/indapamide on major CV events doubled.

Lead researcher Dr Vlado Perkovic, associate professor in renal medicine at the University of Sydney, concluded: ‘This highlights the importance of blood pressure-lowering therapy in preventing renal and cardiovascular complications in this high-risk population.'

European Heart Journal published online 25 May 2010

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