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Blood pressure lowering and 10-year mortality risk in T2D

Lowering blood pressure in people with type 2 diabetes is an effective and important intervention. A large meta-analysis of 40 high-quality trials has reinforced this message as well as quantifying the benefit. The findings included that people with type 2 diabetes with a systolic blood pressure greater than 140 mmHg are most likely to respond and that the different classes of antihypertensive drugs may vary in their outcomes.

by Colin Kenny, GP, Dromore

 

Lowering blood pressure to prevent cardiovascular-related mortality in people with type 2 diabetes is now accepted practice and reinforced by the Quality and Outcomes Framework. In this meta-analysis, researchers combined 40 high-quality clinical trials, including more than 100,000 participants, to evaluate the magnitude of that benefit, to identify subgroups most likely to benefit and to assess the effects of various classes of antihypertensive drugs.

The study found that each 10mm-Hg lowering of systolic blood pressure was associated with a significantly reduced risk of mortality. A significant risk reduction was also noted in cardiovascular events, coronary heart disease, stroke, albuminuria and retinopathy. Generally, the classes of antihypertensive conferred similar benefits, but in lowering the risk of heart failure, diuretics and angiotensin receptor blockers were found to be particularly effective.

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