Intensive Blood-Pressure Control in Patients with Type 2 Diabetes
Abstract
"BACKGROUND
Effective targets for systolic blood-pressure control in patients with type 2 diabetes are unclear.
METHODS
We enrolled patients 50 years of age or older with type 2 diabetes, elevated systolic blood pressure, and an increased risk of cardiovascular disease at 145 clinical sites across China. Patients were randomly assigned to receive intensive treatment (targeting systolic blood pressure <120 mm Hg) or standard treatment (targeting <140 mm Hg) for up to 5 years. The primary outcome was a composite of nonfatal stroke, nonfatal myocardial infarction, treatment or hospitalization for heart failure, or death from cardiovascular causes.
RESULTS
Among 12,821 patients (mean age 63.8 years; 45.3% women), the mean systolic blood pressure at 1 year was 121.6 mm Hg (intensive group) and 133.2 mm Hg (standard group). Over a median follow-up of 4.2 years, primary-outcome events occurred in 393 patients (1.65 events/100 person-years) in the intensive group versus 492 (2.09 events/100 person-years) in the standard group (hazard ratio, 0.79; 95% CI, 0.69–0.90; P<0.001). Symptomatic hypotension and hyperkalemia were more frequent with intensive treatment.
CONCLUSIONS
Intensive blood-pressure control (target <120 mm Hg) significantly reduced major cardiovascular events in patients with type 2 diabetes compared with standard treatment (target <140 mm Hg)."
Keywords:
Type 2 diabetes
intensive blood-pressure control
systolic blood pressure
cardiovascular events
hypertension
randomized controlled trial
BPROAD trial
China
hypotension
hyperkalemia.
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