Blood pressure lowering in patients with type 2 diabetes improves cardiovascular events including mortality, but more intensive lowering to systolic blood pressure less than 130 mm Hg is associated with further reduction in stroke and albuminuria without further reduction in cardiac events

Commentary on: Emdin CA, Rahimi K, Neal B, et al. Blood pressure lowering in type 2 diabetes: a systematic review and meta-analysis. JAMA 2015;313:603–15. Context Hypertension and diabetes are independent risk factors for cardiovascular disease.1 Although lowering blood pressure (BP) reduces cardiovascular events,1 thresholds to initiate antihypertensive therapy and BP targets have been areas of controversy. Until recently, guideline recommendations for BP targets have been more stringent in patients with diabetes. Methods Emdin and colleagues report information from a systematic review of 45 randomised trials. The trials included 104 586 participants with diabetes with higher or lower BP targets. They compared antihypertensive medications with placebo or two antihypertensive medications in this patient group. Outcomes assessed included macrovascular and microvascular outcomes. Findings Overall, lowering systolic BP (SBP) by 10 mm Hg was shown to significantly reduce all-cause mortality, cardiovascular disease, coronary heart disease,...
Source: Evidence-Based Medicine - Category: Internal Medicine Authors: Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease, Renal medicine, Diabetes Therapeutics/Prevention Source Type: research