<International Circulation>:

Can you compare and contrast the differences between ACCORD and ADVANCE?
 

<Prof Cushman>: 

ADVANCE gave two very good medicines: a thiazide diuretic and an ACE inhibitor compared to placebo， on top of other therapies in diabetics. ADVANCE was a bigger population since they put their entire 10000+ people on drug or placebo for blood pressure. ADVANCE was not a blood pressure goal study， so they had no goal at all. They ended up with a mean blood pressure in the intensively treated group of 135mmHg. That is right at or right above what our standard group was， so I do consider ADVANCE a positive study as they did get a 14% reduction in mortality even though the macro-vascular outcomes were not significantly reduced， but overall it was a positive study. To me， it says that our standard group and their intensively treated group which were very similar in blood pressure level， is a good level to be at in diabetics.

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