Journal Article

Effects of Intensive Blood-Pressure Control in Type 2 Diabetes Mellitus

Cushman, William C, Cutler, Jeffrey A, Corson, Marshall A, Byington, Robert P, Evans, Gregory W, Goff, Jr, David C, Bigger, J Thomas, Probstfield, Jeffrey L, Ismail-Beigi, Faramarz, Gerstein, Hertzel C, Katz, Lois, Grimm, Jr, Richard H, Friedewald, William T, Basile, Jan N, Simons-Morton, Denise G, Buse, John B, Peterson, Kevin A

2010

Overview

In a randomized trial, 4733 patients with type 2 diabetes mellitus who were at high risk for cardiovascular events received treatment aimed at a target systolic blood pressure of less than 120 mm Hg or less than 140 mm Hg. At a mean follow-up of 4.7 years, the rates of the primary end point (nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death) were not significantly different between the two trial groups. Patients with type 2 diabetes mellitus who were at high risk for cardiovascular events received treatment aimed at a target systolic blood pressure of less than 120 mm Hg or less than 140 mm Hg. At a mean follow-up of 4.7 years, the rates of the primary end point were not significantly different between the two groups. Diabetes mellitus increases the risk of cardiovascular disease by a factor of two to three at every level of systolic blood pressure. 1 Because cardiovascular risk in patients with diabetes is graded and continuous across the entire range of levels of systolic blood pressure, even at prehypertensive levels, the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) recommended beginning drug treatment in patients with diabetes who have systolic blood pressures of 130 mm Hg or higher, with a treatment goal of reducing systolic blood pressure to below 130 mm Hg. . . .

• Publisher: Massachusetts Medical Society
• Subject: Aged / Antihypertensive Agents - adverse effects / Antihypertensive Agents - therapeutic use / Blood Pressure / Cardiovascular disease / Cardiovascular Diseases - mortality / Cardiovascular Diseases - prevention & control / Creatinine - blood / Diabetes / Diabetes Mellitus, Type 2 - complications / Diabetes Mellitus, Type 2 - drug therapy / Female / Glomerular Filtration Rate - drug effects / Humans / Hypertension / Hypertension - complications / Hypertension - drug therapy / Hypokalemia - chemically induced / Kaplan-Meier Estimate / Male / Middle Aged / Myocardial Infarction - epidemiology / Myocardial Infarction - prevention & control / Proportional Hazards Models / Stroke - epidemiology / Stroke - prevention & control