The ADVANCE trial shows that the combination of perindopril and indapamide can reduce risk for cardiovascular disease and related mortality in patients with diabetes, according to a presentation at the annual meeting of the European Society of Cardiology.

ADVANCE (Action in Diabetes and Vascular Disease), the largest-ever study of treatments for diabetes, also found that the fixed-dose drug therapy reduced risk for development or progression of kidney disease.

One of the study leaders, Professor Stephen MacMahon from The George Institute for International Health in Australia, said "these results represent an important step forward in health care for the millions of people with diabetes worldwide. This treatment reduced the likelihood of dying from the complications of diabetes by almost one-fifth, with virtually no side-effects.”

A total of 11,140 patients with diabetes from 20 countries worldwide participated in the 4.3 year project. Half received daily treatment with a single tablet containing a fixed combination of perindopril and indapamide), whereas the other half were randomized to matching inactive placebo.

Dr. Anushka Patel, Study Director from The George Institute, said “the participants in ADVANCE were already receiving most of the usual treatments provided to patients with diabetes, including other drugs to lower blood pressure. However, addition of the fixed combination of perindopril and indapamide reduced the risk of death from any cause by 14 percent and the risk of death from cardiovascular disease by 18 percent. In absolute terms, one death would be avoided for every 79 patients treated with the fixed combination of perindopril and indapamide for 5 years. The risk of coronary heart disease events was reduced by 14 percent and the risk of new or worsening kidney disease was reduced by 21 percent.”

Professor John Chalmers, the author of previous international guidelines for the treatment of hypertension and chairman of the study management group, said, “the results clearly demonstrate that we have the tools to blunt the impact of the global diabetes epidemic facing rich and poor countries alike. But concerted action is urgently required to ensure that patients with diabetes are identified and provided with treatments proven to improve important outcomes like survival.”