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document
Efficacy and safety of routine blood pressure lowering in older patients with diabetes : results from the ADVANCE trial . OBJECTIVE The efficacy and safety of blood pressure lowering in elderly patients have not been sufficiently investigated in patients with diabetes . Using data from the Action in Diabetes and Vascular disease : preterAx and diamicroN-MR Controlled Evaluation study , we assessed the efficacy and safety of routine blood pressure lowering to prevent major clinical outcomes in elderly patients with type 2 diabetes . METHODS Eleven thousand one hundred and forty patients aged at least 55 years with type 2 diabetes ( mean 66+/-6 years ) were randomly assigned to perindopril-indapamide or placebo . The primary endpoint was a composite of major macrovascular and microvascular disease . The effects of active treatment on outcomes were estimated in subgroups according to age : below 65 , 65-74 and at least 75 years . RESULTS During a mean 4.3-year follow-up , 1799 ( 16.1 % ) patients experienced a major event . Active treatment produced similar relative risk reductions for the primary outcome , major macrovascular disease , death and renal events across age groups ( all P heterogeneity > 0.3 ) . Over 5 years , active treatment was estimated to prevent one primary outcome in every 21 , 71 and 118 patients of at least 75 , 65-74 and below 65 years , respectively . Similar patterns of benefits were observed for secondary outcomes . There were no differences in the tolerability between randomized allocations across age groups ( all P heterogeneity > 0.6 ) CONCLUSION Routine administration of perindopril-indapamide lowers blood pressure safely and reduces the risk of major clinical outcomes in patients of at least 75 years with type 2 diabetes . The greater absolute benefits in older patients in this age group were not offset by an increased risk of side effects .
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Intervention_Physical
blood pressure lowering
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Intervention_Pharmacological
perindopril-indapamide
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Intervention_Control
placebo
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Intervention_Pharmacological
perindopril-indapamide
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Outcome_Other
Efficacy and safety
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Outcome_Physical
blood pressure lowering
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Outcome_Other
efficacy and safety
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Outcome_Physical
blood pressure lowering
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Outcome_Other
efficacy and safety
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Outcome_Physical
blood pressure lowering
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Outcome_Physical
composite of major macrovascular and microvascular disease
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Outcome_Physical
relative risk reductions
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Outcome_Physical
major macrovascular disease
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Outcome_Physical
death
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Outcome_Physical
renal events
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Outcome_Other
tolerability
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Outcome_Physical
blood pressure
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Outcome_Physical
risk
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Outcome_Adverse-effects
side effects .
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Participant_Age
older
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Participant_Condition
diabetes
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Participant_Age
elderly
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Participant_Age
elderly
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Participant_Condition
type 2 diabetes
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Participant_Sample-size
Eleven thousand one hundred and forty
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Participant_Age
aged at least 55 years
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Participant_Condition
type 2 diabetes
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Participant_Age
mean 66+/-6 years