Antihypertensives in Diabetes Patients with BPs <140 Tied to Higher CV Mortality
By Kelly Young
Edited by
- Susan Sadoughi, MD, and
- Richard Saitz, MD, MPH, FACP, FASAM
Use of antihypertensive treatment is associated with increased cardiovascular mortality in patients with diabetes whose baseline systolic blood pressure is below 140 mm Hg, according to a meta-analysis in The BMJ.
Researchers examined the results of 49 randomized trials of BP-lowering interventions involving 74,000 patients with diabetes, mostly type 2. Patients were followed for roughly 4 years.
Patients with a starting systolic BP above 150 mm Hg saw a 25% reduction in cardiovascular mortality risk with BP-lowering therapy. However, among those with a baseline systolic BP below 140, treatment was associated with a 15% increased CV mortality risk.
The authors speculate that intensive therapy in diabetic patients could affect circulation to end organs and result in ischemia. They note that the recent SPRINT trial, which found a mortality benefit with intensive BP lowering, excluded patients with diabetes.
Link(s):
BMJ article (Free)
http://response.jwatch.org/t?ctl=68BB:5FF9B588B7CB016C02435620A62842F2&
Background: NEJM Journal Watch General Medicine coverage of SPRINT study (Free)
http://response.jwatch.org/t?ctl=68BC:5FF9B588B7CB016C02435620A62842F2&
Background: NEJM Journal Watch Cardiology coverage of ACCORD study (Free)
http://response.jwatch.org/t?ctl=68BD:5FF9B588B7CB016C02435620A62842F2&
