Lower Blood Pressure Levels Linked to Improved CV Outcomes in Diabetes

Having lower systolic blood pressure than what is currently recommended in guidelines is associated with significantly decreased risk of cardiovascular events in patients with type 2 diabetes, according to the results of a recent study.

Several hypertension guidelines have recently changed the recommended goal for systolic blood pressure from lower than 130 mm Hg to lower than 140 mm Hg in patients with diabetes.
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To examine the consequences of these changes, researchers conducted a population-based cohort study of 187,106 patients registered in the Swedish national diabetes register. All participants had had diabetes for at least 1 year, were aged 75 or younger, and had no previous cardiovascular or other major diseases.

Overall, those with the lowest systolic blood pressure (110-119 mm Hg) had a significantly lower risk of nonfatal acute myocardial infarction, total acute myocardial infarction, nonfatal cardiovascular disease, total cardiovascular disease, and nonfatal coronary heart disease, compared with those with systolic blood pressure of 130 to 139 mm Hg.

“In conclusion, lower systolic blood pressure than currently recommended is associated with a significantly lower risk of cardiovascular events in patients with type 2 diabetes,”
 the researchers wrote. “The association between low blood pressure and increased mortality could be caused by concomitant disease rather than antihypertensive treatment.”

—Michael Potts

Reference:
Eryd SA, Gudbjörnsdottir S, Manhem K, et al. Blood pressure and complications in individuals with type 2 diabetes and no previous cardiovascular disease: national population based cohort study [published online August 4, 2016). BMJ. doi: http://dx.doi.org/10.1136/bmj.i4070.