Early BP Control Reduces Cardiovascular Risks in Diabetics

Patients with diabetes who fail to control their blood pressure (BP) within the first year of hypertension onset are at increased risk of major cardiovascular events, according to researchers.

Study findings suggest that insufficient attention has been devoted to the aggressive early management of BP in diabetic patients, the researchers said.

Patrick J. O'Connor, MD, MPH, of HealthPartners Research Foundation in Minneapolis, Minn., and colleagues studied 15,665 adult patients with diabetes and new-onset hypertension. The study population had a mean age of 51.5 years and mean BP of 136.8/80.8 mm Hg at hypertension onset. At baseline, none of the patients had a diagnosis of coronary or cerebrovascular disease.

After a mean 38-month follow-up period, subjects whose BP average was at or above 140/90 in the first year of hypertension onset had a significant 30% increased risk of major cardiovascular events (myocardial infarction [MI] or stroke) compared with patients whose BP was below 140/90 , the investigators reported online in Diabetes Care.

The increased risk was due mostly to the increased rate of MI. Patients with average BP at or above 140/90 had a significant 41% increased risk of MI and a non-significant 25% increased risk of stroke.

The study found similar reductions in cardiovascular event risk among patients controlling their BP to below 130/80 compared with 130/80 or higher.

Dr. O'Connor's team acknowledged some study limitations, including the observational design, which precludes causal inference. In addition, the study included only insured patients receiving care in three health systems, limiting the generalizability of study results.

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