Mulberry purses look so fashion

Mulberry purses look so fashion

mulberry bagsBy the end of the trial, he treatment groups were similar in terms of allocated treatments (such as statins) and had similar prevalence of glycemia and cardiovascular risk factors, with the result that achieving the target of a 30% reduction in cardiovascular events with intensive therapy became unlikely, they wrote in the Lancet.

mulberry pursesADDITION -- the Anglo-Danish-Dutch study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care -- included 3,057 patients (age 40 to 69) who screened positive for diabetes at primary care practices in Britain, the Netherlands, and Denmark.

Patients randomized to intensive treatment received:

mulberry walletAntihypertensive treatment starting with an ACE inhibitor at a blood pressure of 120/80 mm Hg or higher, with directions to intensify treatment for blood pressures of 135/85 mm Hg or greater

Lipid-lowering medication at an LDL of 3.5 mmol/L (135 mg/dL) or higher with intensification for those at or above 4.5 mmol/L (174 mg/dL)

Diabetes medications targeting a hemoglobin A1c of 6.5% or less

At the mean 5.3 years of follow-up, all the individual components of the primary cardiovascular event outcome (cardiovascular death, MI, stroke, and revascularization) tended to favor intensive therapy numerically, although without statistical significance.

The researchers pointed to the apparent divergence of cardiovascular event rates beyond four years, suggesting that five years of follow-up may be insufficient if the benefits of more intensive therapy accrue over the long term as in the UKPDS study.

But Griffins group cautioned that they could not rule out chance findings.

The low event rates in both groups -- half what had been expected -- left the trial underpowered, potentially obscuring benefit from intensive therapy, the commentary noted.

Also, participating primary care practices may have been those more motivated to improve their quality of diabetes care, such that the routine care delivered in the trial might not be representative of routine care elsewhere, it added.

The quality of care in the routine primary practice group may just have been too good, the researchers agreed.