Effect of more versus less intensive blood pressure control on cardiovascular, renal and mortality outcomes in people with type 2 diabetes: A systematic review and meta-analysis

Ekaterini Ioannidou; Sharmin Shabnam; Sophia Abner; Navjot Kaur; Francesco Zaccardi; Kausik K. Ray; Samuel Seidu; Melanie J. Davies; Kamlesh Khunti; Clare Gillies

doi:10.1016/j.dsx.2023.102782

May 22, 2023Diabetes & Metabolic Syndrome Clinical Research & ReviewsOpen Access

Effect of more versus less intensive blood pressure control on cardiovascular, renal and mortality outcomes in people with type 2 diabetes: A systematic review and meta-analysis

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Why the study?

Does intensive blood pressure control reduce cardiovascular, renal, and mortality outcomes in patients with type 2 diabetes?

Structured PICO

Does intensive blood pressure control reduce cardiovascular, renal, and mortality outcomes in patients with type 2 diabetes?

P

Population

Patients with type 2 diabetes

I

Intervention

Intensive blood pressure targets (achieving post-treatment level of 125/73 mmHg)

C

Comparator

Standard blood pressure targets

O

Outcome

Cardiovascular, renal and mortality outcomeshard clinical

Intensive blood pressure control significantly reduces stroke and macro-albuminuria in patients with type 2 diabetes, suggesting current targets of 130/80 mmHg could be lowered further.

Implication

Supports intensive BP targets below 130/80 mmHg in type 2 diabetes; extends meta-analytic evidence on stroke and macroalbuminuria reduction.

Abstract

The use of intensive compared with standard blood pressure targets resulted in a significant reduction in blood pressure, stroke, and macro-albuminuria in patients with type 2 diabetes. The post-treatment blood pressure level in the intensive group was 125/73 mmHg, suggesting the current recommendations of 130/80 mmHg blood pressure or lower if tolerated, could be reduced further.