Blood pressure targets for hypertension in people with diabetes mellitus
Key result
Lower blood pressure targets evaluated against standard targets in diabetes mellitus in planned systematic review.
Why the study?
Does lower blood pressure targets (≤ 130/85 mmHg) reduce mortality and morbidity in adults with diabetes mellitus and elevated BP?
Key Points
- To determine whether lower blood pressure targets (≤ 130/85 mmHg) compared with standard blood pressure targets (≤ 140 to 160/90 to 100 mmHg) reduce mortality and morbidity in people with elevated blood pressure and diabetes mellitus.
- Planned Cochrane systematic review protocol of randomized controlled trials (randomization at the individual level) comparing lower versus standard blood pressure targets.
- Eligible participants are non-pregnant, non-lactating adults aged ≥ 18 years with diabetes mellitus and documented elevated blood pressure (systolic BP ≥ 140 mmHg, diastolic BP ≥ 90 mmHg, or on BP-lowering therapy).
- As a protocol for a systematic review, no empirical trial results or pooled effect estimates are presented.
- Pre-specified primary outcomes include all-cause mortality, number of participants with at least one serious adverse event, and total cardiovascular serious adverse events.
- Pre-specified secondary endpoints include systolic and diastolic blood pressure achieved, treatment withdrawals due to adverse effects, and the number of antihypertensive medications required per participant.
Study Design
Type
Systematic Review
Structured PICO
Does lower blood pressure targets (≤ 130/85 mmHg) reduce mortality and morbidity in adults with diabetes mellitus and elevated BP?
P
Population
Protocol for a systematic review of adults with diabetes mellitus and elevated blood pressure to evaluate lower versus standard blood pressure targets.
I
Intervention
Lower blood pressure targets (≤ 130/85 mmHg)
C
Comparator
Standard blood pressure targets (≤ 140 to 160/90 to 100 mmHg)
O
Outcome
All-cause mortality, number of people with at least one serious adverse event, and total cardiovascular serious adverse eventshard clinical
This protocol outlines a planned systematic review to determine the optimal blood pressure targets for patients with diabetes mellitus and hypertension.
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
JEJohn E. AndersonPresident, Science and Medicine, American Diabetes Association
“Patients with diabetes have increased risk of cardiovascular problems like stroke and heart attack and so treatment for blood sugar, blood pressure and cholesterol are of paramount importance. This Cochrane review correlates and conforms to our standards of care at ADA—that we should treat to target a goal of 140 over 80 or less.”
“Surprisingly perhaps, most people assumed it was a recognized fact that we should try to get blood pressure [as low as possible] in this population and therefore additional research wasn't needed. We showed we need more research to really answer the question about how to treat high blood pressure in order to achieve the greatest benefit and the lowest risk for this population.”
Implication
Optimal BP targets remain uncertain in diabetic hypertension; this review will synthesize RCT evidence on mortality and morbidity.
Abstract
OBJECTIVES: This is a protocol for a Cochrane review (intervention). The objectives are as follows: To determine if lower blood pressure (BP) targets (i.e. ≤ 130/85 mmHg), compared with standard BP targets (i.e. ≤ 140 to 160/90 to 100 mmHg) are associated with reduction in mortality and morbidity in people with elevated BP and diabetes mellitus.
Discussion
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Cite This Study
Larvie et al. (2026) conducted a systematic review in Elevated blood pressure and diabetes mellitus. Lower blood pressure targets (≤ 130/85 mmHg) vs. Standard blood pressure targets (≤ 140 to 160/90 to 100 mmHg) was evaluated on All-cause mortality, number of people with at least one serious adverse event, and total cardiovascular serious adverse events. Lower blood pressure targets (≤ 130/85 mmHg) compared with standard targets will be evaluated for their effect on mortality and morbidity in people with diabetes mellitus in this planned systematic review.