A
six-year study of people with type 2 diabetes found that
intensively lowering blood pressure had a long-lasting
effect in preventing heart attacks, strokes and deaths. But
intensive blood sugar control didn't produce those benefits,
the researchers found. For the study, investigators followed
nearly 8,500 participants of a completed diabetes trial.
Some participants had had their blood pressure and blood
sugar levels strictly controlled, while others had received
standard care. The researchers wanted to assess the
long-term effects of the intensive control, which ended when
the trial concluded. "One of the points of doing this study
was to see if lowering blood sugar for five years might,
down the track, translate into protection against stroke and
heart attack -- it didn't," said researcher. The original
study -- dubbed the advance study -- "showed clearly that
patient got these great benefits from blood pressure
reduction and also got some benefit from blood sugar
lowering," he said. The unanswered question, he said, was if
intensive blood pressure and blood sugar control were
stopped, would the benefits go away or last. To find out,
they stopped the intensive treatment, but continued to
follow the trial participants for an additional 5.9 years.
Over that time, they did find a lasting benefit of
intensively lowering blood sugar levels to 6.5 percent in
preventing kidney disease, a common complication of
uncontrolled diabetes, researcher said. "Probably the five
years of treatment we gave them led to changes in the kidney
that continued to protect people for many years after."
Among patients who had their blood pressure reduced in the
original trial to 135/75 mm Hg -- considered intensive
control -- the benefit in reducing the risk of dying from a
heart attack or stroke remained, although to a lesser
degree, as time went by, he added. "The implication is to
continue to take blood pressure drugs if patient want to get
maximum protection," he said. In the trial, gliclazide -- an
older medication -- was the drug used most often to reduce
blood sugar. This is in a class of drugs called
sulfonylureas. It's possible, he said, that a newer diabetes
drug might have a more beneficial effect in preventing heart
attacks and strokes. |