Study Challenges Benefits of Intensive BP Control in Patients with Diabetes

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Intensive BP control does not reduce the rate of a composite outcome of fatal and nonfatal cardiovascular events in patients with type 2 diabetes, according to researchers.

They randomly assigned 4,733 type 2 diabetics to intensive therapy, targeting a systolic pressure less than 120 mm Hg, or standard therapy, targeting a systolic pressure less than 140 mm Hg. The primary outcome was a composite of nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes.

After one year, the mean systolic pressure was 119.3 mm Hg in the intensive-therapy grup and 133.5 mm Hg in the standard-therapy arm. The annual rate of the primary outcome was 1.87% in the intensive-therapy group and 2.09% in the standard-therapy group, a nonsignificant difference between the groups, the investigators reported in The New England Journal of Medicine (published online ahead of print).

The annual rates of death were 1.28% and 1.19%, respectively, also a nonsignificant difference. The annual rates of stroke, however, were 0.32% in the intensive-therapy group and 0.53% in the standard-therapy group, which translated into a significant 41% decreased risk of stroke in the intensive-therapy group.

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