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Evidence-based hypertension treatment in patients with diabetes.
MedLine Citation:
PMID:  22277142     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
J Clin Hypertens (Greenwich). 2011;00:00-00. ©2011 Wiley Periodicals, Inc. Both impaired glucose tolerance and diabetes are associated with substantially increased prevalence of hypertension, cardiovascular and renal disease. The goal for hypertension treatment in diabetic patients is in evolution, because of recent clinical trials. For example, the results of the recent Action to Control Cardiovascular Risk in Diabetes-BP Arm (ACCORD BP) trial failed to show an additional benefit on cardiovascular event reduction at a mean systolic BP of 119 mm Hg. A post hoc analysis of 6,400 patients with type 2 diabetes from the International Verapamil-Trandolapril Study (INVEST) also failed to show additional cardiovascular risk reduction among patients who achieved a BP <130/80 mm Hg. While the evidence fails to support a lower BP goal to reduce coronary events, there was a risk reduction in stroke events both in ACCORD and the Appropriate Blood Pressure Control in NIDDM (ABCD) trial. A number of other clinical trials also demonstrate that when systolic pressures fall to less than 130 mm Hg, a reduction in stroke but not coronary disease events occurs. Thus, the precise BP goal for diabetic patients remains unresolved. We would posit that a BP goal of 135/85 mm Hg may be a reasonable compromise when viewing the impact of BP reduction on composite stroke and coronary artery disease in extant trials.
Authors:
Mariana Garcia-Touza; James R Sowers
Publication Detail:
Type:  Journal Article     Date:  2011-12-19
Journal Detail:
Title:  Journal of clinical hypertension (Greenwich, Conn.)     Volume:  14     ISSN:  1751-7176     ISO Abbreviation:  J Clin Hypertens (Greenwich)     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888554     Medline TA:  J Clin Hypertens (Greenwich)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  97-102     Citation Subset:  IM    
Copyright Information:
© 2011 Wiley Periodicals, Inc.
Affiliation:
From the Division of Endocrinology, Diabetes & Metabolism, Department of Internal Medicine, University of Missouri ; 1 the Department of Medical Physiology and Pharmacology ; 2 and the Harry S. Truman VA Medical Center, Columbia, MO 3.
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