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Commentary on: Emdin CA, Rahimi K, Neal B, et al. Blood pressure lowering in type 2 diabetes: a systematic review and meta-analysis. JAMA 2015;313:603–15.
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.
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.
Overall, lowering systolic BP (SBP) by 10 mm Hg was shown to significantly reduce all-cause mortality, cardiovascular …
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