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