Why the study?
It was unclear whether intensive systolic blood pressure lowering benefits hypertensive patients with diabetes.
Does intensive systolic blood pressure lowering reduce cardiovascular outcomes in hypertensive patients with diabetes?
Population
3989 hypertensive patients with diabetes from STEP and ACCORD-BP trials
Comparison
Intensive vs standard SBP treatment targets
Design
Pooled analysis of individual patient data from two randomized trials
Follow-up
Median 3.83 years
Key result
Intensive systolic blood pressure lowering (110 to <130 mmHg) reduced the composite of stroke, major CAD, heart failure, and CV death compared to standard targets (HR 0.77; 95% CI 0.64-0.93).
Authors
Loading...
Supports intensive SBP targets in diabetic hypertension; confirms CV event reduction from Level 1 evidence.
Meta-Analysis (n=3,989)
Randomized
Yes
Does intensive systolic blood pressure lowering reduce cardiovascular outcomes in hypertensive patients with diabetes?
Effect estimate: HR 0.77 (95% CI 0.64-0.93)
Absolute Event Rate: 9.7% vs 12.3%
Intensive systolic blood pressure lowering (target 110 to <130 mmHg) significantly reduces cardiovascular events in hypertensive patients with diabetes compared to a standard target (130 to <150 mmHg).
Yang et al. (2022) conducted a meta-analysis in Hypertensive patients with diabetes (n=3,989). Intensive systolic blood pressure (SBP) lowering vs. Standard SBP-lowering target of 130 to <150 mmHg was evaluated on Composite of stroke, major coronary artery disease (myocardial infarction and unstable angina), heart failure, and cardiovascular death (HR 0.77, 95% CI 0.64-0.93). Intensive systolic blood pressure lowering (110 to <130 mmHg) reduced the composite of stroke, major CAD, heart failure, and CV death compared to standard targets (HR 0.77; 95% CI 0.64-0.93).