Diabetes mellitus is a major global health problem. Type 2 diabetes is by far the commonest form of diabetes, and is the form that mostly affects adults.
People with diabetes are well known to be at high risk of developing major health problems earlier in life than those without diabetes. In particular, people with diabetes are more likely to suffer from:
- heart attack
- kidney failure
- vascular disease
- peripheral vascular disease
Studies have shown that the risks of complications in people with diabetes are linked to their blood pressure level, with greater risks among those with higher blood pressure levels. While studies have shown that lowering blood pressure in people with diabetes and “hypertension” can avoid some of these complications, many uncertainties remain. In particular, there is new evidence to suggest that even tighter control of blood pressure than is currently recommended might result in even greater benefits. This evidence also suggests that lowering blood pressure even in those considered to have ‘normal’ blood pressure may be beneficial in people with diabetes. However, these hypotheses remain untested, ADVANCE (Action in Diabetes and Vascular Disease) is a large study that will attempt to address some of the unresolved issues relating to blood pressure and blood glucose management in individuals with type 2 diabetes.