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Blood pressure is an important determinant of the risk for vascular events in diabetic patients with hypertension. Current guidelines recommend intensive BP reduction for these patients, titrated to specific goals. Does routine administration of an ACE-inhibitor–diuretic combination reduce vascular events irrespective of initial BP levels or the concomitant use of other antihypertensive drugs?
In this international trial, partially funded by the manufacturer of both drugs, 11,140 patients with type 2 diabetes (mean age, 66; 43% women) were randomly assigned to receive, in addition to any current antihypertensive treatment (except for another ACE-inhibitor or a thiazide diuretic), a fixed daily combination of 2 mg perindopril and 0.625 mg ind…