For people with diabetes, aggressive blood pressure goals may not help

November 13, 2013 by Stephanie Stephens,
For people with diabetes, aggressive blood pressure goals may not help

Many people with diabetes also have high blood pressure. Clinical guidelines have suggested blood pressure levels in people with diabetes should be kept lower than the standard for people without diabetes. However, a new review from The Cochrane Library does not find support for this practice.

"It's been clinical practice to try to decrease as much as possible in this group in order to reduce both mortality and morbidity," said Jose Agustin Arguedas, M.D., professor in the department of clinical pharmacology at the University of Costa Rica. Several frequently used suggest that people with diabetes should have blood pressure less than 130 over 80, he said.

Lowering blood pressure typically means increasing the number or dosage of medications, which can be inconvenient and expensive for patients.

In the new review, the researchers studied five trials with a total of 7,314 participants to evaluate whether targets (less than 130/85 mmHg) for people with diabetes were better than standard blood pressure targets. The review determined that setting blood pressure targets lower than 140 over 90 mmHg in people with diabetes did not lower the risk of heart attack, stroke or death.

"From a diabetes perspective, people with type 2 diabetes have issues other than just blood sugar that determines ultimate risk for complications," said John E. Anderson, M.D. president for science and medicine at the American Diabetes Association. "Patients with have increased risk of cardiovascular problems like stroke and heart attack and so treatment for blood sugar, blood pressure and cholesterol are of paramount importance. This Cochrane review correlates and conforms to our standards of care at ADA—that we should treat to target a goal of 140 over 80 or less."

For some populations, he said, even more aggressive blood pressure targeting might be appropriate if it can be done without undue burden of medication.

"Surprisingly perhaps, most people assumed it was a recognized fact that we should try to get blood pressure [as low as possible] in this population and therefore additional research wasn't needed," noted Arguedas. "We showed we need more research to really answer the question about how to treat in order to achieve the greatest benefit and the lowest risk for this population."

Explore further: 'Smarter' blood pressure guidelines could prevent many more heart attacks and strokes

More information: Arguedas JA, Leiva V, Wright JM. "Blood pressure targets for hypertension in people with diabetes mellitus." Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No.: CD008277. DOI: 10.1002/14651858.CD008277.

Related Stories

New diabetes guidelines may lower patient medical bills

December 21, 2012

(HealthDay)— New guidelines issued by the American Diabetes Association (ADA) Thursday may reduce the number of people who need to take blood pressure medications, and they may help more people get insurance coverage for ...

Free online program helps reduce blood pressure

March 5, 2013

People with high blood pressure enrolled in a clinical pharmacist-led web-based monitoring program were more likely to lower their pressure to recommended level than people who did not use the program.

Recommended for you

New theory on how insulin resistance, metabolic disease begin

September 26, 2016

Does eating too much sugar cause type 2 diabetes? The answer may not be simple, but a study published Sept. 26 in the Journal of Clinical Investigation adds to growing research linking excessive sugar consumption—specifically ...

Unique molecular atlas of pancreas produced

September 23, 2016

Researchers at Karolinska Institutet have managed to produce the first molecular map of the genes that are active in the various cells of the human pancreas. They have also revealed differences in genetic activity between ...

Can long naps cause diabetes?

September 14, 2016

A study presented at a scientific congress Thursday reported a link between long naps and a higher risk of diabetes, though it couldn't say if daytime sleeping was a symptom or a cause.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.