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Systematic review with meta-analysis
Blood pressure lowering in patients with type 2 diabetes improves cardiovascular events including mortality, but more intensive lowering to systolic blood pressure less than 130 mm Hg is associated with further reduction in stroke and albuminuria without further reduction in cardiac events
  1. Bora Toklu,
  2. Sripal Bangalore
  1. Department of Cardiology, New York University School of Medicine, New York, New York, USA
  1. Correspondence to : Dr Sripal Bangalore, Department of Cardiology, New York University School of Medicine, New York, NY 10016, USA; sripalbangalore{at}gmail.com

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Context

Hypertension and diabetes are independent risk factors for cardiovascular disease.1 Although lowering blood pressure (BP) reduces cardiovascular events,1 thresholds to initiate antihypertensive therapy and BP targets have been areas of controversy. Until recently, guideline recommendations for BP targets have been more stringent in patients with diabetes.

Methods

Emdin and colleagues report information from a systematic review of 45 randomised trials. The trials included 104 586 participants with diabetes with higher or lower BP targets. They compared antihypertensive medications with placebo or two antihypertensive medications in this patient group. Outcomes assessed included macrovascular and microvascular outcomes.

Findings

Overall, lowering systolic BP (SBP) by …

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