Key result
Intensive BP control in T2D cuts stroke risk ~36% and trends toward fewer major CV events.
Why the study?
Optimal blood pressure targets for type 2 diabetes remain controversial, and the net benefit of intensive blood pressure control in diabetes is uncertain.
Does intensive blood pressure control reduce stroke and major cardiovascular events in adults with type 2 diabetes?
Does intensive blood pressure control reduce stroke and major cardiovascular events in adults with type 2 diabetes?
In adults with type 2 diabetes, intensive blood pressure control significantly reduces the risk of stroke, but does not show conclusive benefits for overall major cardiovascular events, mortality, or heart failure.
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Supports intensive <130/80 mmHg targets to lower stroke in type 2 diabetes; confirms benefits from general-population RCTs in this high-risk group.
Optimal blood pressure (BP) targets for type 2 diabetes remain controversial. Although intensive BP control reduces cardiovascular risk in the general population, its net benefit in diabetes is uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials comparing intensive BP control (target < 130/80 mmHg or achieved systolic <130 mmHg) with routine control in adults with type 2 diabetes. Databases (PubMed, Embase, Cochrane CENTRAL) were searched through November 2024; two reviewers independently extracted data and assessed bias. Random-effects meta-analysis estimated pooled relative risks (RRs) with 95% confidence intervals (CIs), and trial sequential analysis (TSA) assessed robustness. Eleven trials comprising 24,308 participants met inclusion criteria. Intensive BP control reduced stroke (RR: 0.64; 95% CI: 0.51–0.81) and major cardiovascular events (RR: 0.86; 95% CI: 0.72–1.03) with no significant differences in mortality or heart-failure hospitalization. TSA confirmed firm evidence for stroke reduction, mortality and heart failure results remained inconclusive.
Ikram et al. (2026) studied this question. Intensive BP control (<130/80 mmHg) in type 2 diabetes reduced stroke risk by 36% (RR 0.64) and showed a trend to lower major CV events (RR 0.86).
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