Tuesday, September 25, 2007

Diabetes treatment - more important to treat BP

The European Society of Cardiology, annual scientific meeting has just ended in Vienna, Austria. I did not go, too expensive, but I did follow the presentations on the internet. One of the important trials presented was the ADVANCE trial, where 11,400 diabetics were studied.

Half of them were given placebo and the other half, a combo pill containing natrilix and coversyl. The treatment period was 4.3 years. The investigators found that the combo pill reduces all major cardiac events, including deaths in diabetics. This study is indeed very important. The question arises? Should we give all diabetics blood pressure lowering pills to try and attain a BP of 130/80mmHg? Is it more important in diabetics, to lower BP or to lower blood sugar? Interesting, I must say that with UKPDS and now further confirmed by ADVANCE, in diabetics, lowering BP may be much more important then lowering blood sugar. Maybe, we should do things in moderation. Lower blood sugar moderately and blood pressure aggressively. Even if you BP if normal, keep it at 130.80 mmHg or lower is probably very helpful, and we do not have to worry too much about the blood sugar. Moderate control of blood sugar and keeping BP 130/80 mmHg or lower, is the best thing that you can do, Suffice to say that if you remember the cliche "Diabetes is a cardiovascular disease".

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