Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
September 12, 1998BMJOpen Access

Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38

View Full Paper
Ask AI
Bookmark
Share

Key result

Tight blood pressure control reduced the risk of any diabetes-related endpoint by 24% compared to less tight control in patients with type 2 diabetes.

Why the study?

Does tight control of blood pressure prevent macrovascular and microvascular complications in hypertensive patients with type 2 diabetes?

Population

Hypertensive patients with type 2 diabetes (mean age 56, mean blood pressure at entry 160/94 mm Hg)

Comparison

Tight control of blood pressure aiming at… vs Less tight control aiming at a blood pressure of…

Design

RCT, Stratified randomisation according to previous antihypertensive treatment

Follow-up

median 8.4 years

Authors

UGUK Prospective Diabetes Study GroupOxford Centre for Diabetes, Endocrinology and Metabolism

Discussion

Loading...

Member takes

Implication

Tight BP control should be prioritized in hypertensive type 2 diabetes; reinforces consensus on macrovascular and microvascular risk reduction.

Study Design

Type

RCT (n=1,148)

Blinding

null

Randomization

null

Multicenter

Yes

Structured PICO

Does tight control of blood pressure prevent macrovascular and microvascular complications in hypertensive patients with type 2 diabetes?

P
Population
Hypertensive patients with type 2 diabetes (mean age 56, mean blood pressure at entry 160/94 mm Hg)
I
Intervention
Tight control of blood pressure aiming at <150/85 mm Hg (with the use of captopril or atenolol as main treatment)
C
Comparator
Less tight control aiming at a blood pressure of <180/105 mm Hg (avoiding angiotensin converting enzyme inhibitors and β blockers)
O
Outcome
Time to the occurrence of a first clinical end point related to diabetes, death related to diabetes, and death from all causescomposite

Main Result

Effect estimate: RR 0.76 (95% CI 0.62-0.92)

Absolute Event Rate: 11% vs 14%

p-value: p=0.0046

Tight blood pressure control in patients with hypertension and type 2 diabetes achieves a clinically important reduction in the risk of diabetes-related deaths, macrovascular complications like stroke, and microvascular complications.

Limitations

  • Limited to hypertensive patients with type 2 diabetes
  • Results may not generalize to populations without diabetes or with different comorbidities

Cite This Study

UK Prospective Diabetes Study Group (1998) conducted an RCT in Type 2 diabetes (n=1,148). Captopril or Atenolol vs. Less tight control aiming at < 180/105 mm Hg was evaluated on Any clinical end point related to diabetes (fatal and non-fatal) (RR 0.76, 95% CI 0.62-0.92, p=0.0046). Tight blood pressure control reduced the risk of any diabetes-related endpoint by 24% compared to less tight control in patients with type 2 diabetes.

synapsesocial.com/papers/6966d319fa5be6f252f7bc97https://doi.org/10.1136/bmj.317.7160.703

Topics

Hypertension management
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Hypertension in Diabetes Study (HDS): I. Prevalence of hypertension in newly presenting type 2 diabetic patients and the association with risk factors for cardiovascular and diabetic complications1993 · 492 citations
  2. 2Protection of kidney function and decrease in albuminuria by captopril in insulin dependent diabetics with nephropathy.1988 · 330 citations
  3. 3Diabetes, Other Risk Factors, and 12-Yr Cardiovascular Mortality for Men Screened in the Multiple Risk Factor Intervention Trial1993 · 4,104 citations
  4. 4Development and Progression of Renal Disease in Pima Indians with Non-Insulin-Dependent Diabetes Mellitus1996 · 479 citations
  5. 5A Prospective Study of Maturity-Onset Diabetes Mellitus and Risk of Coronary Heart Disease and Stroke in Women1991 · 648 citations