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Evid Based Med doi:10.1136/eb-2013-101302
  • Therapeutics
  • Systematic review and meta-analysis

Meta-analysis shows limited benefit of lowering blood pressure below 130/80 mm Hg in patients with type 2 diabetes

  1. Aldo J Peixoto
  1. VA Connecticut Healthcare System and Yale University School of Medicine, West Haven, Connecticut, USA
  1. Correspondence to : Aldo J Peixoto
    VA Connecticut Healthcare System and Yale University School of Medicine, Medical Service—111F, 950 Campbell Avenue, West Haven, CT 06518, USA; aldo.peixoto{at}yale.edu

Commentary on: McBrien K, Rabi DM, Campbell N, et al. Intensive and standard blood pressure targets in patients with type 2 diabetes mellitus: systematic review and meta-analysis. Arch Intern Med 2012;172:1296–303.

Context

Although lowering blood pressure (BP) to the standard target of 140/90 mm Hg improves cardiovascular outcomes in patients with type 2 diabetes mellitus (T2DM), the benefits of more intensive lowering to <130/80 mm Hg have not been conclusively demonstrated. Despite this shortcoming, most current practice guidelines recommend this lower target. Two meta-analyses of studies evaluating outcomes according to the level of BP achieved in patients with diabetes1 ,2 or glucose intolerance1 demonstrated that tight BP control resulted in fewer strokes and albuminuria, but had no impact on other cardiovascular events or death.

Methods

The investigators evaluated five randomised clinical trials including 7312 patients with T2DM. The studies compared a standard BP target (systolic BP (SBP) …

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