The active treatment in ADVANCE was well tolerated. By the end of the study, adherence was 73% to the study regimen and 74% to placebo.
An editorial that accompanied the article questioned whether the results were specific for treatment with the perindopril and indapamide combination used in the study, and suggested that any regimen that reduced blood pressure to the same level would probably have the same benefit. Dr. MacMahon made it clear that he agrees with using any safe and effective regimen that brings down a patient's blood pressure.
“The results suggest a broader role for blood pressure lowering. Lowering the blood pressure of everyone with diabetes is a critical component of preventing complications,” he said. “The critical issue is to get as many people as possible on treatment.”
The new findings “will strengthen the current guidelines, and will also push [the guidelines] forward,” commented Dr. Guiseppe Mancia, head of internal medicine at San Gerardo Hospital, Milan, and a co-investigator in the study.