Imperial College London
Alternate

Professor Neil Poulter

Faculty of Medicine, School of Public Health

Professor of Preventive Cardiovascular Medicine.
 
 
 
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Contact

 

+44 (0)20 7594 3446n.poulter

 
 
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Assistant

 

Mrs Ranjit Rayat +44 (0)20 7594 3445

 
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Location

 

55Stadium HouseWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{Juraschek:2022:10.1016/j.ijcard.2022.04.044,
author = {Juraschek, SP and Wang, D and McEvoy, JW and Harrap, S and Harris, K and Mancia, G and Marre, M and Neal, B and Patel, A and Poulter, NR and Williams, B and Chalmers, J and Woodward, M and Selvin, E},
doi = {10.1016/j.ijcard.2022.04.044},
journal = {International Journal of Cardiology},
pages = {103--109},
title = {Effects of glucose and blood pressure reduction on subclinical cardiac damage: Results from ADVANCE},
url = {http://dx.doi.org/10.1016/j.ijcard.2022.04.044},
volume = {358},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVE: Observational data suggest a potential for subclinical cardiac damage from intensive blood glucose or blood pressure (BP) control, particularly in adults with very low blood glucose and BP levels. However, this has not been tested in a randomized trial. METHODS: The Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Research Controlled Evaluation (ADVANCE) study was a factorial, randomized trial designed to test the effects of intensive blood glucose (hemoglobin A1c ≤6.5% versus usual care) and intensive BP (combination of perindopril-indapamide versus placebo) control on vascular events in adults with diabetes. Using mixed effects tobit models, we determined the effect of the randomized interventions on change in subclinical cardiac injury (high sensitivity cardiac troponin T [hs-cTnT]) and strain (N-terminal b-type pro natriuretic peptide [NT-proBNP]), 1 year after randomization. RESULTS: Among the 682 participants, mean age was 66.1 (SD, 6.5) years; 40% were women. Mean baseline hemoglobin A1c was 7.4% (SD, 1.5) and systolic/diastolic BP was 147 (SD,21)/81 (SD,11) mmHg. After 1 year, intensive versus standard glucose control did not significantly change hs-cTnT (1.5%; 95%CI:-4.9,8.2) or NT-proBNP (-10.3%; 95%CI: -20.2%,0.9%). Intensive versus standard BP control also did not affect hs-cTnT (-2.9%; 95%CI: -8.9,3.6), but did significantly lower NT-proBNP by 21.6% (95%CI:-30.2%,-11.9%). Changes in systolic BP at 1 year (versus baseline) were strongly associated with NT-proBNP (P = 0.004), but not hs-cTnT (P = 0.95). CONCLUSIONS: In adults with diabetes, intensive BP control reduced NT-proBNP without increasing hs-cTnT, supporting the benefits and safety of intensive BP control in adults with diabetes. This trial is registered at clinicaltrials.gov, number: NCT00145925.
AU  - Juraschek,SP
AU  - Wang,D
AU  - McEvoy,JW
AU  - Harrap,S
AU  - Harris,K
AU  - Mancia,G
AU  - Marre,M
AU  - Neal,B
AU  - Patel,A
AU  - Poulter,NR
AU  - Williams,B
AU  - Chalmers,J
AU  - Woodward,M
AU  - Selvin,E
DO  - 10.1016/j.ijcard.2022.04.044
EP  - 109
PY  - 2022///
SN  - 0167-5273
SP  - 103
TI  - Effects of glucose and blood pressure reduction on subclinical cardiac damage: Results from ADVANCE
T2  - International Journal of Cardiology
UR  - http://dx.doi.org/10.1016/j.ijcard.2022.04.044
UR  - https://www.ncbi.nlm.nih.gov/pubmed/35439582
UR  - http://hdl.handle.net/10044/1/97504
VL  - 358
ER  -
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