What question did this study set out to answer?

This research aims to determine the best systolic blood pressure targets for preventing major cardiovascular events in patients with type 2 diabetes.

May 31, 2023HypertensionOpen Access

Systolic Blood Pressure Control Targets to Prevent Major Cardiovascular Events and Death in Patients With Type 2 Diabetes: A Systematic Review and Network Meta-Analysis

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Why the study?

Previous meta-analyses did not support intensive SBP control in diabetes and included trials published before 2015, leaving the optimal SBP targets uncertain.

Does intensive systolic blood pressure control reduce major cardiovascular events in patients with type 2 diabetes?

Population

59 934 patients with type 2 diabetes across 30 trials

Comparison

Different blood pressure targets, antihypertensive agents vs placebo, or dual vs single agents

Design

Systematic review and network meta-analysis of randomized controlled trials

Authors

QYQianqian YangRuijin Hospital RZRuizhi ZhengRuijin Hospital SWSiyu WangGuiyang Medical University

Discussion

Member takes

Implication

Supports targeting achieved SBP 120-124 mm Hg in type 2 diabetes; extends network meta-analysis evidence on optimal achieved levels.

Key Points

This research aims to determine the best systolic blood pressure targets for preventing major cardiovascular events in patients with type 2 diabetes.
Conducted a systematic review and network meta-analysis of randomized controlled trials.
Compared various blood pressure targets and antihypertensive therapies in patients with type 2 diabetes.
Analyzed data from 30 trials involving 59,934 patients, focusing on the impact of achieved SBP levels on clinical outcomes.
The lowest risk of major cardiovascular events was linked to achieved SBP levels of 120 to 124 mm Hg (HR 0.73, 95% CI 0.52-1.02 compared to 130 to 134 mm Hg).
Significantly lower hazard ratios were observed for higher SBP levels (HR 0.60 and HR 0.41 compared to 140-144 mm Hg and ≥150 mm Hg, respectively).
Achieving an SBP below 140 mm Hg reduced all-cause mortality, but no additional benefits were seen with lower targets.

Structured PICO

Does intensive systolic blood pressure control reduce major cardiovascular events in patients with type 2 diabetes?

Population

59,934 patients with type 2 diabetes pooled from 30 randomized controlled trials

Intervention

Intensive systolic blood pressure control (achieved SBP 120-124 mm Hg)

Comparator

Less intensive systolic blood pressure control (achieved SBP 130-134 mm Hg, 140-144 mm Hg, or ≥150 mm Hg)

Outcome

Major cardiovascular diseases eventscomposite

Intensive blood pressure lowering to an achieved SBP of 120-124 mm Hg significantly reduces the risk of major cardiovascular events in patients with type 2 diabetes compared to higher SBP targets.

Cite This Study

Yang et al. (2023) studied this question.

synapsesocial.com/papers/6a08537d0df715653be8a7a1 https://doi.org/10.1161/hypertensionaha.123.20954

Topics

Hypertension management Cardiovascular prevention

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Systolic Blood Pressure Control Targets to Prevent Major Cardiovascular Events and Death in Patients With Type 2 Diabetes: A Systematic Review and Network Meta-Analysis

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Systolic Blood Pressure Control Targets to Prevent Major Cardiovascular Events and Death in Patients With Type 2 Diabetes: A Systematic Review and Network Meta-Analysis

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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