Key result
Targeting BP below 130/80 mmHg may cause more harm than benefit in long-term diabetes.
Why the study?
Does treating blood pressure to targets below 130/80 mmHg improve cardiovascular outcomes in patients with long-term established diabetes?
Does treating blood pressure to targets below 130/80 mmHg improve cardiovascular outcomes in patients with long-term established diabetes?
Aggressive blood pressure lowering below 130/80 mmHg in patients with long-term established diabetes may be harmful, emphasizing the need for individualized, multifactorial treatment.
May caution against BP targets below 130/80 mmHg in long-standing diabetes; leaves open need for dedicated RCTs before practice change.
Treatment of blood pressure in the patient with diabetes remains a challenge. While data extrapolated from many trials seemed to imply that lower blood pressures leads to more favorable cardiovascular outcomes, this paper reviews newer trials designed to treat to blood pressure targets below 130/80 mmHg in patients with long term established diabetes, which showed that this goal may prove more harmful than helpful. In clinical practice this may be less relevant due to the fact that less than half of patients are even at the goal of 130/80. The interaction between glucose control and blood pressure control are also discussed, emphasizing the importance of multifactorial treatment.
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Glandt et al. (2011) conducted a review in Hypertension in Diabetes. Blood pressure targets below 130/80 mmHg was evaluated. Treating blood pressure to targets below 130/80 mmHg in patients with long-term established diabetes may prove more harmful than helpful.
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