Lower BP Targets Reduce Cardiovascular Events Risk
Intensive BP drops may lower cardiovascular risks in both patients with and without diabetes.
(HealthDay News) — Intensive blood pressure lowering may similarly decrease cardiovascular events in both patients with and patients without type 2 diabetes mellitus, according to a study published in Diabetes Care.
Tom F Brouwer, MD, from the University of Amsterdam, and colleagues assessed the effect of both type 2 diabetes and baseline cardiovascular disease risk on the treatment effect of intensive blood pressure lowering based on data and pooled analysis from two randomized trials (ACCORD-BP [Action to Control Cardiovascular Risk in Diabetes Blood Pressure]and SPRINT [Systolic Blood Pressure Intervention Trial] studies; total of 14,094 patients).
The researchers found that the mean baseline systolic blood pressure was 139.5 mm Hg for the cohort and just over one-third (33.6%) had type 2 diabetes. The hazard ratio for the primary composite end point of unstable angina, myocardial infarction, acute heart failure, stroke, and cardiovascular death was 0.82 (P = 0.0017). There was a nonsignificant interaction between intensive blood pressure lowering and type 2 diabetes (P = 0.13). While the 10-year cardiovascular risk was higher in patients with type 2 diabetes, there was no interaction between the risk and treatment effect (P = 0.84).
"Intensive blood pressure lowering may have a similar favorable effect and appears to decrease cardiovascular events in both patients with and patients without type 2 diabetes mellitus," the authors write.
Brouwer TF, Vehmeijer JT, Kallman DN, et al. Intensive blood pressure lowering in patients with and patients without type 2 diabetes: a pooled analysis from two randomized trials. Diabetes Care. 2017 Dec. doi: 10.2337/dc17-1722.