Key result
Intensive BP lowering is evaluated against standard targets for cardiovascular event prevention in diabetes.
Why the study?
The effect of intensive BP reduction on preventing cardiovascular events in patients with diabetes remained unclear.
Does intensive blood pressure-lowering treatment (targeting SBP < 130 mmHg or DBP < 80 mmHg) reduce cardiovascular events compared to standard blood pressure treatment in patients with diabetes?
Meta-Analysis (n=28,954)
Randomized controlled trials
Yes
Does intensive blood pressure-lowering treatment (targeting SBP < 130 mmHg or DBP < 80 mmHg) reduce cardiovascular events compared to standard blood pressure treatment in patients with diabetes?
Intensive blood pressure lowering targeting SBP < 130 mmHg or DBP < 80 mmHg significantly reduces major cardiovascular events—particularly stroke—in patients with diabetes without significantly increasing serious adverse events.
Answers are grounded in this paper and cite their sources.
Supports intensive BP targets in diabetes; extends 9-RCT meta-analysis confirming CV event and stroke reduction.
The effect of intensive blood pressure (BP) reduction on the prevention of cardiovascular events in patients with diabetes remains unclear. This study evaluated the impact of intensive BP-lowering on cardiovascular events in patients with diabetes compared to standard treatment. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted, comparing intensive treatment (target systolic BP < 130 mmHg or diastolic BP < 80 mmHg) with standard treatment in patients with diabetes. Eligible studies were identified through Ovid MEDLINE, Cochrane Library, and Ichushi. Outcomes included cardiovascular events, coronary artery disease, stroke, all-cause and cardiovascular death, and serious adverse events. Data were analyzed using a random-effects model. Sensitivity analyses were performed to assess the effects of systolic and diastolic BP targets separately. The search identified eight eligible trials comprising 16634 patients with diabetes. Intensive BP-lowering treatment significantly reduced cardiovascular events (risk ratio: 0.848; 95% confidence interval: 0.760, 0.947) and stroke (risk ratio: 0.705; 95% confidence interval: 0.541, 0.918), but not coronary artery disease or all-cause death in analyses including J-DOIT3 trial. Sensitivity analyses showed that DBP-targeted treatment was not associated with the risk of cardiovascular events. Incorporating the latest RCT strengthened the association between intensive treatment and reduced coronary artery disease risk, without significantly increasing the risk of serious adverse events. These findings recommend an intensive BP-lowering strategy targeting SBP < 130 mmHg or DBP < 80 mmHg to prevent cardiovascular events, particularly stroke, in patients with diabetes.
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Abe et al. (2025) conducted a meta-analysis in Diabetes mellitus and hypertension (n=28,954). Intensive blood pressure-lowering treatment vs. Standard blood pressure-lowering treatment (Target SBP <130 to <150 mmHg or DBP ≤85 to ≤90 mmHg) was evaluated on Cardiovascular events. Intensive blood pressure-lowering treatment was evaluated against standard blood pressure targets for preventing cardiovascular events across 9 randomized trials of 28,954 patients with diabetes.
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