In a new study published in the Journal of American Heart Association Hypertension, individuals with type 2 diabetes who received intensive treatment to keep their blood pressure levels at 130/80 mm/Hg or below had fewer heart attacks, strokes, and other diabetes complications. Apart from that, the study also revealed that these patients also had a lower overall risk of dying from any cause, a benefit that was observed regardless of a person's pre-existing cardiovascular risk and baseline blood pressure.
The study revealed new information concerning optimal blood-pressure targets and could help reconcile conflicting guidelines for the treatment for hypertension in people with type 2 diabetes, the more common form of the disease affecting more than 420 million people worldwide.
The senior investigator of the research, J. Bill McEvoy, M.B., B.C.H., professor of preventive cardiology at the National University of Ireland, Galway Campus, and the Irish National Institute of Preventive Cardiology, said that their discoveries demonstrate a benefit of more intensive therapy aiming for blood pressure threshold at 130/80 or below and should help resolve some ongoing confusion over optimal blood pressure targets for people with diabetes.
McEvoy added that patients, as well as those with diabetes, with blood pressure levels above 130/80 or two consecutive checks should discuss with their physicians whether they need a change in treatment to get a lower number.
The guideline for the 2017 American College of Cardiology and American Heart Foundation blood pressure call for beginning anti-hypertensive treatment at a blood pressure of 130/80 mmHg or higher for adults with diabetes and hypertension, to reduce blood pressure to below 130/80 mmHg.
The findings of the new Hypertension study are based on analysis of outcomes among nearly 11,000 patients with type 2 diabetes followed over four years across 215 clinical centers in 20 countries as part of the international study ADVANCE.
The team compared results between moderate to high cardiovascular risk people with type 2 diabetes and hypertension, a condition defined as persistently elevated blood pressure, receiving anti-hypertension combination treatment, perindopril and indapamide, and individuals with diabetes and hypertension receiving a placebo.
However, there was a report already about the benefit of this trial overall for the additional hypertension treatment; little was known whether this benefit also applied to people with diabetes who started with blood pressure below 140/90 mmHg. For the researchers to determine treatment benefit, they analyzed to compare rates of overall death from any causes as well as the percentage of major vascular events such as heart attacks, strokes, diabetes-related kidney disease, and diabetes-related eye damage.
