Evaluating intensive blood pressure treatment for patients with diabetes

This study evaluated the optimal blood pressure (BP) control in patients with diabetes. This study concluded that intensive BP therapy was associated with a significantly lower risk for cardiovascular events.

Uncontrolled BP remains a leading cause of cardiovascular diseases and death in patients with diabetes. Ideal BP targets for patients with diabetes remain controversial. The American Heart Association recommends a target BP of less than 130/80 mmHg. However, the American Diabetes Association recommends a target of less than 140/90 mmHg. Which BP target recommendations may be generalizable to a broader population of patients with diabetes remains under investigation.

This study involved clinical trial data from a total of 6,450 adults with diabetes. 4,507 patients (ACCORD study) had a BP target of less than 120 mmHg (intensive control group). 1,943 patients (NHANES study) had a BP target of less than 140 mmHg (standard control group). The risk of cardiovascular (heart and blood vessels) events, such as heart attack stroke or death, were evaluated.

The risk of death did not differ between the intensive and standard therapy groups. However, intensive BP therapy was associated with a 67% lower risk of stroke. Overall, the risk of cardiovascular events was 33% lower in patients in the intensive treatment group.

Serious side effects were 97% more common in the intensive therapy group compared to the standard therapy group.

This study concluded that intensive BP therapy was associated with a significantly lower risk for cardiovascular events in patients with diabetes.

Patients in the ACCORD study had less racial/ethnic diversity and more cardiovascular risk factors. These results may not be applicable for certain racial and ethnic minorities or patients with lower cardiovascular risk.

Further studies are needed to better inform BP treatment guidelines.