Effects of perindopril-indapamide on left ventricular diastolic function and mass in patients with type 2 diabetes: The ADVANCE Echocardiography Substudy

Robert N. Doughty, ADVANCE Collaborative Group

Research output: Contribution to journalArticleResearchpeer-review

14 Citations (Scopus)

Abstract

Background: The Action in Diabetes and Vascular Disease (ADVANCE) Study demonstrated that a fixed combination of perindopril and indapamide reduced the risk of major vascular events and mortality in patients with type 2 diabetes. This Echocardiographic Substudy was designed to determine the effects of this treatment on left ventricular diastolic function and left ventricular mass. Methods: Five hundred and fifty-five patients entering ADVANCE underwent quantitative echocardiography prior to randomization and after 6 months and 4 years of treatment with perindopril-indapamide or placebo. Main end points were left ventricular diastolic function (ratio of mitral E velocity/early medial mitral annular tissue Doppler velocity, E/Em, and left atrial volume index) and left ventricular mass index. Results: Overall, blood pressure was reduced in the perindopril-indapamide group compared with placebo. E/Em and left atrial volume index both increased over the 4 years. There was no effect of perindopril-indapamide on E/Em, although there was a small attenuation of the increase in left atrial volume index with active treatment. Left ventricular mass index was reduced by 2.7 g/m with active treatment (95% confidence interval -5.0 to -0.1, P = 0.04). Conclusion: Compared with placebo, the perindopril-indapamide combination reduced blood pressure and left ventricular mass in patients with diabetes, but did not improve left ventricular diastolic function. Left ventricular diastolic function worsened in both groups over 4 years, despite blood pressure reduction and reduction in left ventricular mass. Improving left ventricular diastolic function remains a challenge in patients with diabetes.

Original languageEnglish
Pages (from-to)1439-1447
Number of pages9
JournalJournal of Hypertension
Volume29
Issue number7
DOIs
Publication statusPublished - Jul 2011

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Indapamide
Perindopril
Left Ventricular Function
Type 2 Diabetes Mellitus
Echocardiography
Placebos
Blood Pressure
Therapeutics
Random Allocation
Vascular Diseases
Blood Vessels
Confidence Intervals
Mortality

Cite this

@article{5be248e5d234470fb745e573fdcdc201,
title = "Effects of perindopril-indapamide on left ventricular diastolic function and mass in patients with type 2 diabetes: The ADVANCE Echocardiography Substudy",
abstract = "Background: The Action in Diabetes and Vascular Disease (ADVANCE) Study demonstrated that a fixed combination of perindopril and indapamide reduced the risk of major vascular events and mortality in patients with type 2 diabetes. This Echocardiographic Substudy was designed to determine the effects of this treatment on left ventricular diastolic function and left ventricular mass. Methods: Five hundred and fifty-five patients entering ADVANCE underwent quantitative echocardiography prior to randomization and after 6 months and 4 years of treatment with perindopril-indapamide or placebo. Main end points were left ventricular diastolic function (ratio of mitral E velocity/early medial mitral annular tissue Doppler velocity, E/Em, and left atrial volume index) and left ventricular mass index. Results: Overall, blood pressure was reduced in the perindopril-indapamide group compared with placebo. E/Em and left atrial volume index both increased over the 4 years. There was no effect of perindopril-indapamide on E/Em, although there was a small attenuation of the increase in left atrial volume index with active treatment. Left ventricular mass index was reduced by 2.7 g/m with active treatment (95{\%} confidence interval -5.0 to -0.1, P = 0.04). Conclusion: Compared with placebo, the perindopril-indapamide combination reduced blood pressure and left ventricular mass in patients with diabetes, but did not improve left ventricular diastolic function. Left ventricular diastolic function worsened in both groups over 4 years, despite blood pressure reduction and reduction in left ventricular mass. Improving left ventricular diastolic function remains a challenge in patients with diabetes.",
author = "Doughty, {Robert N.} and Whalley, {G. A.} and Gamble, {G. D.} and J. Baker and J. Chalmers and M. Cooper and K. Cruickshank and P. Dixon and P. Dunne and D. Eccleston and G. Jerums and R. Luke and B. McGrath and C. Nolan and A. Patel and N. Poulter and P. Phillips and R. Scott and J. Singh and R. Smith and A. Stanton and M. Suranyi and S. Thom and M. Woodward and G. Jerums and H. Walsh and S. MacMahon and E. Ferrannini and P. Glasziou and D. Grobbee and P. Hamet and S. Harrap and S. Heller and Liu, {L. S.} and G. Mancia and M. Marre and Mogensen, {C. E.} and B. Neal and Pan, {C. Y.} and A. Rodgers and B. Williams and C. Jacklin and K. McNeil and P. Srivastava and T. Arsov and M. Correcha and M. Hines and F. Margrie and U. Musial and N. Petrovsky and D. Silva and L. Socha and J. Sutherland and K. Gordijn and K. Grigarius and C. Meyer and R. Singh and H. Teede and J. Wong and A. Yeap and S. Zoungas and C. Allman and J. Chow and M. Curtale and D. Leung and B. Malkus and G. Rayment and T. Spicer and M. Wong and S. MacKintosh and C. Miller and Phillips, {P. A.} and S. Stranks and P. Taylor and S. Baker and L. Bittinger and R. Cotton and P. Harvey and B. Jackson and L. Laqui and V. Lawlor and Liaw, {S. T.} and C. Neil and M. Park and E. Premaratne and F. Pyrlis and G. Rudge and Cruickshank, {J. K.} and M. Banerjee and J. Collins and J. Dunkerley and C. Harrison and K. Hart and M. Holland and R. Khattar and M. Luckson and S. Shaw and T. Wood and R. Elkeles and J. Mayet and A. Sharp and A. Whitehouse and J. Mackay and J. Bunker and W. Callister and C. Coghlan and R. Fernandez and V. Gordon and J. Harman and N. Jugnee and L. Knisley and A. McKerracher and S. Mitchell and S. Murphy and A. Strain and O. Trainor and B. Aloul and C. Collier and E. Dolan and C. Foley and B. Gallagher and B. Gusau and L. Hacke and E. Ho and S. Lyons and B. Maguire and T. Morgan and C. Thompson and M. Twohill and C. Florkowski and A. Kwon and R. McEwan and P. McGregor and M. Milne and C. Strey and R. Troughton and G. Brown and V. D'Ath and J. Kenyon and R. Leikis and R. Clarke and A. Dissanayake and S. Gunatilaka and J. Leary and I. Rosen and {Te Whiu}, M. and H. Walsh and S. Austin and R. Clarke and L. Howitt and G. Ward and G. Carswell and P. Hansen and M. Lane and D. Nesdale and P. Dunn and R. Fisher and E. Reda and A. Johnstone and L. McLeod and F. Bartley and A. Waterman and J. Jensen and D. Owens and T. Clarke and P. Cresswell and A. Ferguson and M. Simmonds and S. Winter and {ADVANCE Collaborative Group}",
year = "2011",
month = "7",
doi = "10.1097/HJH.0b013e3283480fe9",
language = "English",
volume = "29",
pages = "1439--1447",
journal = "Journal of Hypertension",
issn = "0263-6352",
publisher = "Lippincott Williams & Wilkins",
number = "7",

}

Effects of perindopril-indapamide on left ventricular diastolic function and mass in patients with type 2 diabetes : The ADVANCE Echocardiography Substudy. / Doughty, Robert N.; ADVANCE Collaborative Group.

In: Journal of Hypertension, Vol. 29, No. 7, 07.2011, p. 1439-1447.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Effects of perindopril-indapamide on left ventricular diastolic function and mass in patients with type 2 diabetes

T2 - The ADVANCE Echocardiography Substudy

AU - Doughty, Robert N.

AU - Whalley, G. A.

AU - Gamble, G. D.

AU - Baker, J.

AU - Chalmers, J.

AU - Cooper, M.

AU - Cruickshank, K.

AU - Dixon, P.

AU - Dunne, P.

AU - Eccleston, D.

AU - Jerums, G.

AU - Luke, R.

AU - McGrath, B.

AU - Nolan, C.

AU - Patel, A.

AU - Poulter, N.

AU - Phillips, P.

AU - Scott, R.

AU - Singh, J.

AU - Smith, R.

AU - Stanton, A.

AU - Suranyi, M.

AU - Thom, S.

AU - Woodward, M.

AU - Jerums, G.

AU - Walsh, H.

AU - MacMahon, S.

AU - Ferrannini, E.

AU - Glasziou, P.

AU - Grobbee, D.

AU - Hamet, P.

AU - Harrap, S.

AU - Heller, S.

AU - Liu, L. S.

AU - Mancia, G.

AU - Marre, M.

AU - Mogensen, C. E.

AU - Neal, B.

AU - Pan, C. Y.

AU - Rodgers, A.

AU - Williams, B.

AU - Jacklin, C.

AU - McNeil, K.

AU - Srivastava, P.

AU - Arsov, T.

AU - Correcha, M.

AU - Hines, M.

AU - Margrie, F.

AU - Musial, U.

AU - Petrovsky, N.

AU - Silva, D.

AU - Socha, L.

AU - Sutherland, J.

AU - Gordijn, K.

AU - Grigarius, K.

AU - Meyer, C.

AU - Singh, R.

AU - Teede, H.

AU - Wong, J.

AU - Yeap, A.

AU - Zoungas, S.

AU - Allman, C.

AU - Chow, J.

AU - Curtale, M.

AU - Leung, D.

AU - Malkus, B.

AU - Rayment, G.

AU - Spicer, T.

AU - Wong, M.

AU - MacKintosh, S.

AU - Miller, C.

AU - Phillips, P. A.

AU - Stranks, S.

AU - Taylor, P.

AU - Baker, S.

AU - Bittinger, L.

AU - Cotton, R.

AU - Harvey, P.

AU - Jackson, B.

AU - Laqui, L.

AU - Lawlor, V.

AU - Liaw, S. T.

AU - Neil, C.

AU - Park, M.

AU - Premaratne, E.

AU - Pyrlis, F.

AU - Rudge, G.

AU - Cruickshank, J. K.

AU - Banerjee, M.

AU - Collins, J.

AU - Dunkerley, J.

AU - Harrison, C.

AU - Hart, K.

AU - Holland, M.

AU - Khattar, R.

AU - Luckson, M.

AU - Shaw, S.

AU - Wood, T.

AU - Elkeles, R.

AU - Mayet, J.

AU - Sharp, A.

AU - Whitehouse, A.

AU - Mackay, J.

AU - Bunker, J.

AU - Callister, W.

AU - Coghlan, C.

AU - Fernandez, R.

AU - Gordon, V.

AU - Harman, J.

AU - Jugnee, N.

AU - Knisley, L.

AU - McKerracher, A.

AU - Mitchell, S.

AU - Murphy, S.

AU - Strain, A.

AU - Trainor, O.

AU - Aloul, B.

AU - Collier, C.

AU - Dolan, E.

AU - Foley, C.

AU - Gallagher, B.

AU - Gusau, B.

AU - Hacke, L.

AU - Ho, E.

AU - Lyons, S.

AU - Maguire, B.

AU - Morgan, T.

AU - Thompson, C.

AU - Twohill, M.

AU - Florkowski, C.

AU - Kwon, A.

AU - McEwan, R.

AU - McGregor, P.

AU - Milne, M.

AU - Strey, C.

AU - Troughton, R.

AU - Brown, G.

AU - D'Ath, V.

AU - Kenyon, J.

AU - Leikis, R.

AU - Clarke, R.

AU - Dissanayake, A.

AU - Gunatilaka, S.

AU - Leary, J.

AU - Rosen, I.

AU - Te Whiu, M.

AU - Walsh, H.

AU - Austin, S.

AU - Clarke, R.

AU - Howitt, L.

AU - Ward, G.

AU - Carswell, G.

AU - Hansen, P.

AU - Lane, M.

AU - Nesdale, D.

AU - Dunn, P.

AU - Fisher, R.

AU - Reda, E.

AU - Johnstone, A.

AU - McLeod, L.

AU - Bartley, F.

AU - Waterman, A.

AU - Jensen, J.

AU - Owens, D.

AU - Clarke, T.

AU - Cresswell, P.

AU - Ferguson, A.

AU - Simmonds, M.

AU - Winter, S.

AU - ADVANCE Collaborative Group

PY - 2011/7

Y1 - 2011/7

N2 - Background: The Action in Diabetes and Vascular Disease (ADVANCE) Study demonstrated that a fixed combination of perindopril and indapamide reduced the risk of major vascular events and mortality in patients with type 2 diabetes. This Echocardiographic Substudy was designed to determine the effects of this treatment on left ventricular diastolic function and left ventricular mass. Methods: Five hundred and fifty-five patients entering ADVANCE underwent quantitative echocardiography prior to randomization and after 6 months and 4 years of treatment with perindopril-indapamide or placebo. Main end points were left ventricular diastolic function (ratio of mitral E velocity/early medial mitral annular tissue Doppler velocity, E/Em, and left atrial volume index) and left ventricular mass index. Results: Overall, blood pressure was reduced in the perindopril-indapamide group compared with placebo. E/Em and left atrial volume index both increased over the 4 years. There was no effect of perindopril-indapamide on E/Em, although there was a small attenuation of the increase in left atrial volume index with active treatment. Left ventricular mass index was reduced by 2.7 g/m with active treatment (95% confidence interval -5.0 to -0.1, P = 0.04). Conclusion: Compared with placebo, the perindopril-indapamide combination reduced blood pressure and left ventricular mass in patients with diabetes, but did not improve left ventricular diastolic function. Left ventricular diastolic function worsened in both groups over 4 years, despite blood pressure reduction and reduction in left ventricular mass. Improving left ventricular diastolic function remains a challenge in patients with diabetes.

AB - Background: The Action in Diabetes and Vascular Disease (ADVANCE) Study demonstrated that a fixed combination of perindopril and indapamide reduced the risk of major vascular events and mortality in patients with type 2 diabetes. This Echocardiographic Substudy was designed to determine the effects of this treatment on left ventricular diastolic function and left ventricular mass. Methods: Five hundred and fifty-five patients entering ADVANCE underwent quantitative echocardiography prior to randomization and after 6 months and 4 years of treatment with perindopril-indapamide or placebo. Main end points were left ventricular diastolic function (ratio of mitral E velocity/early medial mitral annular tissue Doppler velocity, E/Em, and left atrial volume index) and left ventricular mass index. Results: Overall, blood pressure was reduced in the perindopril-indapamide group compared with placebo. E/Em and left atrial volume index both increased over the 4 years. There was no effect of perindopril-indapamide on E/Em, although there was a small attenuation of the increase in left atrial volume index with active treatment. Left ventricular mass index was reduced by 2.7 g/m with active treatment (95% confidence interval -5.0 to -0.1, P = 0.04). Conclusion: Compared with placebo, the perindopril-indapamide combination reduced blood pressure and left ventricular mass in patients with diabetes, but did not improve left ventricular diastolic function. Left ventricular diastolic function worsened in both groups over 4 years, despite blood pressure reduction and reduction in left ventricular mass. Improving left ventricular diastolic function remains a challenge in patients with diabetes.

UR - http://www.scopus.com/inward/record.url?scp=79958767956&partnerID=8YFLogxK

U2 - 10.1097/HJH.0b013e3283480fe9

DO - 10.1097/HJH.0b013e3283480fe9

M3 - Article

VL - 29

SP - 1439

EP - 1447

JO - Journal of Hypertension

JF - Journal of Hypertension

SN - 0263-6352

IS - 7

ER -