Effect of intensive blood pressure and blood glucose control on cardiovascular outcomes driven by reductions in cardiovascular death and nephropathy: Win ratio analysis of ADVANCE Trial.
Severine, B., Laurent, B., Anushka, P., Mark, W., Katie, H., Stephen, H., Giuseppe, M., Neil, P., & John, C. (2026). Effect of intensive blood pressure and blood glucose control on cardiovascular outcomes driven by reductions in cardiovascular death and nephropathy: Win ratio analysis of ADVANCE Trial.. Eur Heart J Cardiovasc Pharmacother. https://doi.org/10.1093/ehjcvp/pvag026
Severine B, Laurent B, Anushka P, Mark W, Katie H, Stephen H, et al. Effect of intensive blood pressure and blood glucose control on cardiovascular outcomes driven by reductions in cardiovascular death and nephropathy: Win ratio analysis of ADVANCE Trial.. Eur Heart J Cardiovasc Pharmacother. 2026; doi: 10.1093/ehjcvp/pvag026
Severine B, Laurent B, Anushka P, et al. Effect of intensive blood pressure and blood glucose control on cardiovascular outcomes driven by reductions in cardiovascular death and nephropathy: Win ratio analysis of ADVANCE Trial.[J]. Eur Heart J Cardiovasc Pharmacother. 2026. DOI: 10.1093/ehjcvp/pvag026.
@article{severine2026,
author = {Bompoint Severine and Billot Laurent and Patel Anushka and Woodward Mark and Harris Katie and Harrap Stephen and Mancia Giuseppe and Poulter Neil and Chalmers John},
title = {Effect of intensive blood pressure and blood glucose control on cardiovascular outcomes driven by reductions in cardiovascular death and nephropathy: Win ratio analysis of ADVANCE Trial.},
journal = {Eur Heart J Cardiovasc Pharmacother},
year = {2026},
doi = {10.1093/ehjcvp/pvag026},
note = {PMID: 42056835},
}
TY - JOUR AU - Bompoint Severine AU - Billot Laurent AU - Patel Anushka AU - Woodward Mark AU - Harris Katie AU - Harrap Stephen AU - Mancia Giuseppe AU - Poulter Neil AU - Chalmers John TI - Effect of intensive blood pressure and blood glucose control on cardiovascular outcomes driven by reductions in cardiovascular death and nephropathy: Win ratio analysis of ADVANCE Trial. T2 - Eur Heart J Cardiovasc Pharmacother PY - 2026 DO - 10.1093/ehjcvp/pvag026 AN - PMID:42056835 ER -
To re-analyse the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation) trial using the win ratio approach to better understand the relative contributions of individual outcomes in a composite endpoint. We applied an unmatched win ratio analysis to the 11,140 participants of the ADVANCE trial, comparing intervention and control groups for blood pressure and glucose control. Outcomes were prioritised hierarchically by severity: cardiovascular death, non-fatal stroke, non-fatal myocardial infarction, nephropathy, and retinopathy. The ADVANCE trial is registered with ClinicalTrials.gov, number NCT00145925. For blood pressure lowering, the perindopril-indapamide group had a win ratio of 1.11 (95% CI 1.01 to 1.22, p=0.028) compared to placebo and a net benefit of 1.5% (95% CI 0.2% to 2.8%) for a number needed to treat (NNT) of 68 patients. For intensive glucose control, the win ratio was 1.10 (95% CI 1.01 to 1.20, p=0.027) compared to standard glucose control with a net benefit of 1.6% (95% CI 0.2% to 3.0%) for a NNT of 63 patients. When both interventions were combined the win ratio increased to 1.19 (95% CI 1.04 to 1.35, p=0.010) and the NNT decreased to 41 patients. Cardiovascular death and nephropathy were the main contributors to the observed benefits. The win ratio approach confirms the robustness of the original ADVANCE findings while providing a more detailed understanding of the relative importance of individual outcomes. This method enhances the interpretation and communication of composite endpoint analyses.