January 1, 2015Medical Principles and PracticeOpen Access

Metformin: An Old Drug for the Treatment of Diabetes but a New Drug for the Protection of the Endothelium

Q: What are the key findings of this study?

Tight blood pressure control in patients with type 2 diabetes reduced the risk of diabetes-related endpoints by 24% (95% CI 8% to 38%; P=0.0046) compared to less tight control.

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Type 2 diabetes with hypertension (n=1148). Intervention: Tight blood pressure control (captopril or atenolol) vs. Less tight blood pressure control (<180/105 mm Hg). Primary outcome: Diabetes related end points (Risk reduction 24%, 95% CI 8% to 38%, p=0.0046).

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Key result

Tight BP control cuts diabetes-related endpoints ~24% vs less tight control in type 2 diabetes.

Risk reduction 24%
95% CI 8% to 38%
P=0.0046
n=1,148

Why the study?

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

Population

1148 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, Randomised

Follow-up

median 8.4 years

Authors

MKMustafa KinaanUniversity of Central Florida HDHong DingSichuan University CTChris R. TriggleVascular / Pulmonary Vascular

Discussion

Member takes

Implication

Supports tight BP control in hypertensive type 2 diabetes; confirms macrovascular and microvascular risk reduction.

Study Design

Type

RCT (n=1,148)

Randomization

Randomised

Multicenter

Yes

Structured PICO

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

Population

1148 hypertensive patients with type 2 diabetes, mean age 56, mean blood pressure at entry 160/94 mm Hg

Intervention

Tight control of blood pressure aiming at <150/85 mm Hg (with the use of an angiotensin converting enzyme inhibitor captopril or a beta blocker atenolol as main treatment)

Comparator

Less tight control aiming at a blood pressure of <180/105 mm Hg

Outcome

Predefined clinical end points, fatal and non-fatal, related to diabetes, deaths related to diabetes, and all cause mortalitycomposite

Main Result

Effect estimate: Risk reduction 24% (95% CI 8% to 38%)

p-value: p=0.0046

Tight blood pressure control in hypertensive patients with type 2 diabetes significantly reduces the risk of diabetes-related deaths, strokes, and microvascular complications.

Cite This Study

Kinaan et al. (2015) conducted an RCT in Type 2 diabetes with hypertension (n=1,148). Tight blood pressure control (captopril or atenolol) vs. Less tight blood pressure control (<180/105 mm Hg) was evaluated on Diabetes related end points (Risk reduction 24%, 95% CI 8% to 38%, p=0.0046). Tight blood pressure control in patients with type 2 diabetes reduced the risk of diabetes-related endpoints by 24% (95% CI 8% to 38%; P=0.0046) compared to less tight control.

synapsesocial.com/papers/6a0853f0ef79633196e8b033 https://doi.org/10.1159/000381643

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January 1, 2015Medical Principles and PracticeOpen Access

Metformin: An Old Drug for the Treatment of Diabetes but a New Drug for the Protection of the Endothelium

View Full Paper

Ask AI

Bookmark

Key result

Tight BP control cuts diabetes-related endpoints ~24% vs less tight control in type 2 diabetes.

Risk reduction 24%
95% CI 8% to 38%
P=0.0046
n=1,148

Why the study?

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

Population

1148 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, Randomised

Follow-up

median 8.4 years

Authors

MKMustafa KinaanUniversity of Central Florida HDHong DingSichuan University CTChris R. TriggleVascular / Pulmonary Vascular

Discussion

Member takes

Implication

Supports tight BP control in hypertensive type 2 diabetes; confirms macrovascular and microvascular risk reduction.

Study Design

Type

RCT (n=1,148)

Randomization

Randomised

Multicenter

Yes

Structured PICO

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

Population

1148 hypertensive patients with type 2 diabetes, mean age 56, mean blood pressure at entry 160/94 mm Hg

Intervention

Tight control of blood pressure aiming at <150/85 mm Hg (with the use of an angiotensin converting enzyme inhibitor captopril or a beta blocker atenolol as main treatment)

Comparator

Less tight control aiming at a blood pressure of <180/105 mm Hg

Outcome

Predefined clinical end points, fatal and non-fatal, related to diabetes, deaths related to diabetes, and all cause mortalitycomposite

Main Result

Effect estimate: Risk reduction 24% (95% CI 8% to 38%)

p-value: p=0.0046

Tight blood pressure control in hypertensive patients with type 2 diabetes significantly reduces the risk of diabetes-related deaths, strokes, and microvascular complications.

Cite This Study

synapsesocial.com/papers/6a0853f0ef79633196e8b033 https://doi.org/10.1159/000381643

Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

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