AHA: Intensive Strategy for Lowering Systolic BP Beneficial in Type 2 Diabetes

WEDNESDAY, Nov. 20, 2024 (HealthDay News) -- For patients with type 2 diabetes and elevated systolic blood pressure, an intensive-treatment strategy is better than a standard-treatment strategy for incidence of major cardiovascular disease events, according to a study published online Nov. 16 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions 2024, held from Nov. 16 to 18 in Chicago.

Yufang Bi, M.D., Ph.D., from the Shanghai Institute of Endocrine and Metabolic Diseases, and colleagues enrolled patients aged 50 years or older with type 2 diabetes, elevated systolic blood pressure, and an increased risk for cardiovascular disease at 145 clinical sites across China to examine effective targets for systolic blood pressure control. Patients were randomly assigned to receive up to five years of intensive treatment targeting systolic blood pressure of less than 120 mm Hg or standard treatment targeting systolic blood pressure of less than 140 mm Hg (6,414 and 6,407 patients, respectively).

The researchers found that at one year of follow-up, mean systolic blood pressure was 121.6 and 133.2 mm Hg in the intensive-treatment and standard-treatment groups, respectively. During a median follow-up of 4.2 years, primary outcome events (nonfatal stroke, nonfatal myocardial infarction, treatment or hospitalization for heart failure, or death from cardiovascular causes) occurred in 393 and 492 patients in the intensive-treatment and standard-treatment groups, respectively (1.65 and 2.09 events per 100 person-years, respectively; hazard ratio, 0.79). The treatment groups had a similar incidence of serious adverse events.

"The benefits of intensive treatment were consistent across all prespecified subgroups," the authors write.

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