Lowering blood pressure reduces renal events in type 2 diabetes

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dc.contributor.author De Galan, BE en
dc.contributor.author Perkovic, V en
dc.contributor.author Ninomiya, T en
dc.contributor.author Pillai, Avineshwaran en
dc.contributor.author Patel, A en
dc.contributor.author Cass, A en
dc.contributor.author Neal, B en
dc.contributor.author Poulter, N en
dc.contributor.author Harrap, S en
dc.contributor.author Mogensen, CE en
dc.contributor.author Cooper, M en
dc.contributor.author Marre, M en
dc.contributor.author Williams, B en
dc.contributor.author Hamet, P en
dc.contributor.author Mancia, G en
dc.contributor.author Woodward, M en
dc.contributor.author Glasziou, P en
dc.contributor.author Grobbee, DE en
dc.contributor.author MacMahon, S en
dc.contributor.author Chalmers, J en
dc.date.accessioned 2012-06-06T00:20:06Z en
dc.date.issued 2009 en
dc.identifier.citation Journal of the American Society of Nephrology 20:883-892 Article number 4 2009 en
dc.identifier.issn 1046-6673 en
dc.identifier.uri http://hdl.handle.net/2292/18881 en
dc.description.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 < 0.0001), which was driven by reduced risks for developing microalbuminuria and macroalbuminuria (both P < 0.003). Effects of active treatment were consistent across subgroups defined by baseline systolic or diastolic BP. Lower systolic BP levels during follow-up, even to <110 mmHg, was associated with progressively lower rates of renal events. In conclusion, BP-lowering treatment with perindopril-indapamide administered routinely to individuals with type 2 diabetes provides important renoprotection, even among those with initial BP <120/70 mmHg. We could not identify a BP threshold below which renal benefit is lost. en
dc.publisher American Society of Nephrology en
dc.relation.ispartofseries Journal of the American Society of Nephrology en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title Lowering blood pressure reduces renal events in type 2 diabetes en
dc.type Journal Article en
dc.identifier.doi 10.1681/ASN.2008070667 en
pubs.begin-page 883 en
pubs.volume 20 en
dc.rights.holder Copyright: American Society of Nephrology en
dc.identifier.pmid 19225038 en
pubs.end-page 892 en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 295834 en
pubs.org-id Science en
pubs.org-id Statistics en
pubs.number 4 en
pubs.record-created-at-source-date 2012-02-16 en
pubs.dimensions-id 19225038 en


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