What matters in ADVANCE and ADVANCE-ON

摘要: Most recent meta-analyses of morbidity-mortality risk hazards brought about by the presence diabetes as compared with non-diabetics underline dominant renal disease and cardiovascular outcomes relevance blood glucose, pressure (BP) cholesterol levels. The translation this reality into therapeutic guidelines always requires interventional evidence. Evidence for combined approaches in controlling BP glucose was provided Action Diabetes Vascular disease: PreterAx DiamicroN-MR Controlled Evaluation (ADVANCE), conducted over 11 000 subjects from 20 countries. Reduction systolic 7.1 mm Hg, diastolic 2.9 Hg glycated haemoglobin A1c 0.61% points routine lowering intensive glucose-control group after an average 4.3 years follow-up resulted a relative reduction 28% events, 24% death 18% all-cause mortality. While other major intervention trials performed similar populations analogous goals did not achieve same level positive evidence even pointed to some intensified treatment type 2 diabetes, all three studies [Action Control Cardiovascular Risk (ACCORD), Veterans Affairs Trial (VADT) ADVANCE] showed significant diabetes. divergence underlines importance considering specific control prudent targets BP. current target values 6.5-7% 130/80 mmHg appear safe beneficial. potential long-term benefit, particularly that initial tight control, suggested post-trial is currently being evaluated ADVANCE-ON study.