Blood Pressure Drugs Benefit Pre-Hypertension Diabetes

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For every 10 mm Hg decrease in systolic blood pressure, the risk of stroke fell by 27%.
For every 10 mm Hg decrease in systolic blood pressure, the risk of stroke fell by 27%.

(HealthDay News) -- A new analysis indicates that people with type 2 diabetes are less likely to suffer myocardial infarctions, strokes, or early mortality when they take blood pressure medications -- even if they don't actually have hypertension. The study was published in the Feb. 10 issue of the Journal of the American Medical Association.

Kazem Rahimi, M.D., deputy director with the George Institute for Global Health at the University of Oxford in the United Kingdom, and colleagues analyzed 40 studies with a total of 100,354 participants randomized to blood pressure-lowering treatment or placebo.

Each decrease of 10 mm Hg in systolic blood pressure reading reduced the risk of early death by 13%, myocardial infarctions and similar problems by 11%, coronary heart disease by 12%, and stroke by 27%. The researchers also found that the risk of albuminuria and retinopathy fell, by 17 and 13%, respectively. The positive effect of the drugs was smaller in participants with lower blood pressure levels.

Bryan Williams, M.D., a professor of medicine with University College London who studies hypertension and diabetes, said the review findings suggest "we should consider lowering blood pressure further than recommended in current guidelines" to reduce the risk of stroke. 

Williams, who wrote a commentary accompanying the review, told HealthDay: "If I was a younger diabetic, I would certainly want my blood pressure well controlled, always below 140/90 mm Hg and below 130/80 mm Hg if possible. As patients get older, they sometimes tolerate such aggressive treatment less well, but it is worth trying to reach a level of blood pressure that is as low as tolerated without symptoms."

Sources

  1. Connor A. Emdin, CA, et al. JAMA. 2015;313(6):603-615. doi:10.1001/jama.2014.18574.
  2. Williams, Bryan. JAMA. 2015;313(6):573-574. doi:10.1001/jama.2015.89.
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