(HealthDay News) — Intensive blood pressure (BP) therapy is associated with significantly lower risk for cardiovascular events based on data reweighted to better reflect the US adult population with diabetes, according to a study published in the Journal of the American College of Cardiology.
Seth A. Berkowitz, MD, from the University of North Carolina at Chapel Hill, and colleagues reweighted individual patient data from the Action to Control Cardiovascular Risk in Diabetes BP trial (4507 patients) to better represent the demographic and clinical risk factors of adults with diabetes in the United States. Data were also included from the National Health and Nutrition Examination Survey from 2005 to 2014 (1943 patients with diabetes). The objective was to estimate how results from the largest clinical trial of intensive BP treatment among adults with diabetes would generalize to the US population.
The researchers found that weighted results significantly favored intensive BP treatment versus unweighted results (hazard ratio for primary outcome in intensive versus standard treatment in weighted analyses, 0.67, 95% confidence interval, 0.49 to 0.91; hazard ratio for unweighted analyses, 0.88, 95% confidence interval, 0.73 to 1.07). The weighted results over 5 years estimated 34 as the number needed to treat to avoid one cardiovascular event and 55 as the number needed to harm.
“These findings favor intensive BP treatment, but also highlight the lack of data support for BP treatment guidance in large segments of the US adult population with diabetes mellitus particularly racial/ethnic minorities and those with lower cardiovascular risk,” the authors write.
Berkowitz SA, Sussman JB, Jonas DE, and Basu S. Generalizing Intensive Blood Pressure Treatment to Adults With Diabetes Mellitus. J Am Coll Cardiol. 72(11). September 2018DOI: 10.1016/j.jacc.2018.07.012
Bakris GL and Polonsky TS. Presence of Diabetes Does Not Mandate Lower Blood Pressure to Reduce Cardiovascular Events. J Am Coll Cardiol.