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Intensive blood sugar treatment in trial of diabetes and cardiovascular disease changed

NHLBI has stopped one treatment within the ACCORD study, a large, ongoing North American clinical trial of diabetes and cardiovascular disease 18 months early due to safety concerns after review of available data, although the study will continue.

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Keywords: intensive, blood, sugar, treatment, trial, diabetes, cardiovascular, disease, changed, diabete

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1. New medical finding: Treatment for gum disease could also help the heart
   03-02-2007 · EurekAlert!
   Scientists at University College London (UCL) have conducted the first clinical trial to demonstrate that an intensive treatment for periodontitis (gum disease) directly improves the health of blood vessels. This study, conducted in conjunction with Professor Maurizio Tonetti (University of Connecticut, USA), and reported in the latest edition of the New England Journal of Medicine, may have relevance for the prevention of heart attacks and stroke.
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2. Advance in understanding of blood pressure gene could lead to new treatments
   02-04-2007 · EurekAlert!
   Research by scientists at UCL (University College London) has clearly demonstrated for the first time the structure and function of a gene crucial to the regulation of blood pressure. The discovery could be important in the search for new treatments for illnesses such as heart disease, the UK's biggest killer. In a paper published online today in Nature Medicine, the team, led by Professor Patrick Vallance and Dr James Leiper, UCL Department of Medicine, reveal the role of the human gene dimethylarginine dimethylaminohydrolase (DDAH), showing that loss of DDAH activity disrupts nitric oxide (NO) production. NO is critical in the regulation of blood pressure, nervous system functions and the immune system. The role of DDAH is to break down modified amino acids (Asymmetric dimethylarginine (ADMA) and monomethyl arginine (L-NMMA)) that are produced by the body and have been shown to inhibit NO synthase. These molecules accumulate in various disease states including diabetes, renal failure and pulmonary and systemic hypertension, and their concentration in plasma (the fluid component of blood) is strongly predicative of cardiovascular disease and death. In a healthy human body, the majority of ADMA is eliminated through active metabolism by DDAH. Scientists have hypothesised that if DDAH function is impaired, NO production is reduced, and that this could be an important feature of increased cardiovascular risk. To examine this pathway in more detail, the researchers deleted the DDAH gene in mice. These mice went on to develop hypertension, or high blood pressure. They also designed specific inhibitors (small molecules) which bind to the active site of human DDAH. These small molecule inhibitors also induced hypertension in mice, confirming the importance of DDAH in the regulation of blood pressure. Dr Leiper, UCL Medicine, said: “These genetic and chemical approaches to disrupt DDAH showed remarkably consistent results, and provide compelling evidence that loss of DDAH function increases the concentration of ADMA and thereby disrupts vascular NO signalling. “There has been considerable scientific interest in this pathway and the role of ADMA as a novel risk factor, but so far there's been little evidence to support the idea that it's a cause of disease, rather than just a marker. Genes and their pathways are crucial to our understanding of cardiovascular disease and a better understanding of DDAH-1 could lead to important new treatments. “It could help us to establish if genetic variation predisposes certain people to these diseases, or whether environmental factors exert some of their effects through modulation of DDAH activity. “Our research also shows that this pathway could be harnessed therapeutically to limit production of NO in certain situations where too much nitric oxide is a bad thing; for example, hypotension and septic shock. These are some of the biggest problems in intensive care medicine and there is a huge unmet need for drug treatments.” The study, which was carried out at UCL's Rayne Institute, was funded by grants from the British Heart Foundation, the Wellcome Trust and the Medical Research Council. Professor Jeremy Pearson, Associate Medical Director of the British Heart Foundation, said: "The unexpected finding in the 1980s that a simple gas, nitric oxide (NO), is made by cells in the blood vessel wall and is a powerful control of blood vessel relaxation led to the award of the Nobel Prize in 1998 to its discoverers. "More recently, there has been increasing evidence that impairment of NO production is likely to be an important factor in the development of heart and circulatory disease, but the mechanisms responsible are not fully understood. "This study suggests for the first time that the loss of the activity of the enzyme DDAH-1 leads to reduced NO production and may cause heart and circulatory disease. These findings are likely to be important in the search for new ways to optimise the health of our blood vessels." ### Notes for Editors 1. For more information, please contact Ruth Metcalfe in the UCL Media Relations Office on tel: +44 (0)20 7679 9739, mobile: +44 (0)7990 675 947, out of hours: +44 (0)7917 271 364, e-mail: r.metcalfe@ucl.ac.uk2. 'Disruption of methylarginine metabolism impairs vascular homeostasis' is published in the February issue of the journal Nature Medicine. Advance online publication is embargoed to 18.00 GMT (13.00 US Eastern) Sunday 4 February 2007. Journalists can obtain copies of the paper by contacting the UCL Media Relations Office.3. The study was funded by the British Heart Foundation, the Wellcome Trust and the Medical Research Council. About UCL Founded in 1826, UCL was the first English university established after Oxford and Cambridge, the first to admit students regardless of race, class, religion or gender, and the first to provide systematic teaching of law, architecture and medicine. In the government's most recent Research Assessment Exercise, 59 UCL departments achieved top ratings of 5* and 5, indicating research quality of international excellence. UCL is the fourth-ranked UK university in the 2006 league table of the top 500 world universities produced by the Shanghai Jiao Tong University. UCL alumni include Mahatma Gandhi (Laws 1889, Indian political and spiritual leader); Jonathan Dimbleby (Philosophy 1969, writer and television presenter); Junichiro Koizumi (Economics 1969, Prime Minister of Japan); Lord Woolf (Laws 1954, Lord Chief Justice of England & Wales); Alexander Graham Bell (Phonetics 1860s, inventor of the telephone), and members of the band Coldplay.
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3. When it comes to walking, it's all good, says Mayo Clinic researcher
   07-11-2007 · EurekAlert!
   These days, it's easy for people to get confused about exercise -- how many minutes a day should they spend working out, for how long and at what exertion level? Conflicting facts and opinions abound, but one Mayo Clinic physician says the bottom line is this: Walking is good, whether the outcome measurement is blood pressure, diabetes, cardiovascular disease, joint problems or mental health.
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4. New pan-European guidelines on the treatment of diabetes, cardiovascular and VHD published
   02-06-2007 · EurekAlert!
   The first, pan-European guidelines to be published on the treatment of valvular heart disease, diabetes and cardiovascular diseases have made a series of new recommendations which experts hope will contribute to improving the outcome of patients with these diseases.
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5. First step in developing heart hormone-based pill to control high blood pressure
   03-27-2007 · EurekAlert!
   In an era of increasing death and illness from heart and blood vessel disease -- which also can impair kidney function -- Mayo Clinic researchers have designed two promising new cardiovascular treatment approaches.
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6. Sex, sugar and metabolic disease
   11-08-2007 · EurekAlert!
   Overweight children and adults have low blood levels of the protein SHGB, which transports sex steroids and regulates their tissue entry. Low levels of SHGB are a marker of the metabolic syndrome, a medical disorder that increases an individual's risk of developing type 2 diabetes and heart disease. New research in mice and in vitro using human cells provides an explanation as to why low SHGB levels are a good marker of the metabolic syndrome.
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7. Women with high or increasing blood pressure are up to three times more likely to develop diabetes
   10-09-2007 · EurekAlert!
   One of the largest studies to investigate the relationship between blood pressure and type 2 diabetes has found that women who have high blood pressure levels are three times more likely to develop diabetes than women with low blood pressure levels. This effect was independent of body mass index and other conditions that are known to predispose people to cardiovascular disease and diabetes, researchers report in the European Heart Journal.
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8. Pioglitazone lowers cardiovascular risk in diabetic patients with kidney disease
   12-12-2007 · EurekAlert!
   A new study confirms that chronic kidney disease increases the already-high risk of serious cardiovascular events in diabetic patients with damage to the large blood vessels and suggests that treatment with the antidiabetic drug pioglitazone may help to lower this risk, reports the January Journal of the American Society of Nephrology.
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9. Intense cessation treatment proves successful in high-risk smokers
   02-12-2007 · EurekAlert!
   New research published in the February issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP), suggests that high-risk smokers with acute cardiovascular disease are three to four times more likely to quit smoking when treated with an intensive smoking cessation program.
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10. ENDEAVOR III Trial reports key findings on new-generation stent
    05-10-2007 · EurekAlert!
    New data reported at the 30th Annual Scientific Sessions of the Society for Cardiovascular Angiography and Interventions, May 9-12, 2007, in Orlando, Fla., will offer clues to the fate of a new-generation drug-eluting stent that is vying for a place in the treatment of coronary artery disease.
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