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22 February 2009 – A combination of two blood pressure lowering treatments has significantly reduced the risk of kidney disease among patients with type 2 diabetes. The findings, reported by The George Institute for Global Health reveal that blood pressure lowering is beneficial to all patients with diabetes, even for patients with normal blood pressure levels.

An estimated 250 million people are living with diabetes around the world. Kidney disease is a common (more than half of type 2 diabetes patients develop renal impairment) and devastating complication of diabetes - up to 20% of people with diabetes die of renal failure.

"Our research demonstrated that lowering blood pressure with an ACE inhibitor/diuretic combination reduces the risk of kidney complications by 20%, and even resolves some early manifestations of kidney disease in people with diabetes, regardless of whether their blood pressure is normal or elevated," said co-author, Dr Vlado Perkovic, The George Institute for Global Health.

The key findings of the paper, published in the Journal of the American Society of Nephrology, shows that this treatment has wide benefits for all patients with type 2 diabetes. "For all people with diabetes, reducing their risk of kidney disease is imperative. Individuals who develop kidney disease are at significantly increased risk of developing cardiovascular complications, which is the major cause of death in these patients," added Dr Perkovic.

The ADVANCE (Action in Diabetes and Vascular Disease) study was initiated and designed by Australia’s George Institute for International Health and involved a group of independent medical researchers from 20 countries worldwide. This new analysis aimed to examine the effects of blood pressure lowering on kidney disease in people with diabetes and a broad range of blood pressure levels.

ADVANCE involved 11,140 patients with type 2 diabetes who were treated and followed up for five years. One group received a combination of two antihypertensive (blood pressure-lowering) drugs: the angiotensin-converting enzyme (ACE) inhibitor perindopril and the diuretic drug indapamide. The other group received inactive placebos.


Further Information

Media Contact
Emma Orpilla - Public Relations,
The George Institute for Global Health
Tel: +612 9993 4500/ Mobile: +61410 411 983
Fax: +612 9993 4501/ email: eorpilla@george.org.au

The George Institute for Global Health is an internationally-recognised health research organisation, undertaking high impact research across a broad health landscape. Affiliated with the University of Sydney, the Institute is a leader in the clinical trials, health policy and capacity-building areas. The Institute has a global network of top medical experts in a range of research fields as well as expertise in research design, project management and data and statistical analysis. With a respected voice among global policy makers, The Institute has attracted significant funding support from governments, philanthropic organisations and corporations. George Institute research is regularly published in the top tier of academic journals internationally.

ADVANCE was designed, conducted, monitored, analysed and reported by a collaborative medical research group supported by the Australian Government’s National Health and Medical Research Council after full peer review. The study was carried out independently of the industry sponsor and the Management Committee, whose membership did not include any industry representatives, had final responsibility for the reporting of results.

The first results from the ADVANCE study were published in 2007. Reference: ADVANCE Collaborative Group; Patel A, MacMahon S, Chalmers J, Neal B et al. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet 2007; 370:829-40.

The second results of ADVANCE were published in 2008. Reference: Effects of intensive blood glucose control on vascular outcomes in patients with type 2 diabetes mellitus: results of the ADVANCE trial. N Engl J Med 2008;358:2560-72.