Does an aggressive systolic BP goal (<130 mm Hg) reduce macrovascular and microvascular events compared to a goal of 130-135 mm Hg in patients with T2DM/IFG/IGT?
In patients with T2DM or impaired fasting glucose, aggressive systolic BP targets <130 mm Hg reduce stroke risk but do not improve other vascular outcomes and increase serious adverse events compared to a target of 130-135 mm Hg.
The present body of evidence suggests that in patients with type 2 diabetes mellitus/impaired fasting glucose/impaired glucose tolerance, a systolic BP treatment goal of 130 to 135 mm Hg is acceptable. However, with more aggressive goals (<130 mm Hg), we observed target organ heterogeneity in that the risk of stroke continued to fall, but there was no benefit regarding the risk of other macrovascular or microvascular (cardiac, renal and retinal) events, and the risk of serious adverse events even increased.
Bangalore et al. (Wed,) studied this question.