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Combo Blood Pressure-Lowering Regimen Good for Kidneys

Perindopril-indapamide beneficial in type 2 diabetes, even with baseline blood pressure 120/70 or less

THURSDAY, Feb. 19 (HealthDay News) -- A blood pressure-lowering treatment strategy of perindopril-indapamide may prevent renal dysfunction in some patients with type 2 diabetes, regardless of baseline blood pressure level, according to the results of a study published online Feb. 18 in the Journal of the American Society of Nephrology.

Bastiaan E. de Galan, of the University of Sydney in Australia, and colleagues evaluated the effects of reducing blood pressure among 11,140 patients with type 2 diabetes enrolled in the ADVANCE study. Regardless of baseline blood pressure level, patients were randomized to receive the blood pressure-lowering medications perindopril and indapamide or placebo, and followed-up for a mean of 4.3 years.

Patients who received the blood pressure-lowering regimen experienced a 21 percent decreased risk of renal events over the follow-up period, a significant reduction compared with patients who received placebo, the researchers report. This was primarily attributed to a decreased incidence of microalbuminuria and macroalbuminuria. When patients were evaluated according to baseline blood pressure, renal benefit was observed across all subgroups, and no threshold was found below which a renal benefit was not observed, the authors note.

"This simple, well-tolerated treatment strategy prevented one renal event among every 20 patients who were treated for five years," de Galan and colleagues write. "These data therefore suggest that blood pressure lowering may be considered routinely for the prevention of renal complications in all patients with diabetes, regardless of the baseline blood pressure level."

Servier provided funding for the study; several study authors report financial relationships with Servier.

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