02200nas a2200277 4500000000100000008004100001260001700042100001500059700002200074700001800096700001700114700001800131700001900149700001500168700001500183700001400198700001400212700001400226700001600240700001500256700001800271245014600289250001500435520142600450020004601876 2012 d c-358210815641 aGrobbee D.1 avan der Schouw Y.1 avan Dieren S.1 aKengne Andre1 aWoodward Mark1 aZoungas Sophia1 aBeulens J.1 aPoulter N.1 aHarrap S.1 aMancia G.1 aCooper M.1 aChalmers J.1 aNeal Bruce1 aPatel Anushka00aEffects of blood pressure lowering on cardiovascular outcomes in different cardiovascular risk groups among participants with type 2 diabetes a2012/06/093 a
AIMS: To asses differences in treatment effects of a fixed combination of perindopril-indapamide on major clinical outcomes in patients with type 2 diabetes across subgroups of cardiovascular risk. METHODS: 11,140 participants with type 2 diabetes, from the ADVANCE trial, were randomized to perindopril-indapamide or matching placebo. The Framingham equation was used to calculate 5-year CVD risk and to divide participants into two risk groups, moderate-high risk (<25% and no history of macrovascular disease), very high risk (>25% and/or history of macrovascular disease). Endpoints were macrovascular and microvascular events. RESULTS: The mean age of participants was 66 years (42.5% female). 1000 macrovascular and 916 microvascular events were recorded over follow-up of 4.3 years. Relative treatment effects were similar across risk groups, (all P-values for heterogeneity >/=0.38). Hazard ratios for combined macro- and microvascular events were 0.89 (0.77-1.03) for the moderate-high risk and 0.92 (0.81-1.03) for the very high risk. Absolute treatment effects tended to be greater in the high risk groups although differences were not statistically significant (P>0.05). CONCLUSIONS: Relative effects of blood pressure lowering with perindopril-indapamide on cardiovascular outcomes were similar across risk groups whilst absolute effects trended to be greater in the high risk group.
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