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Review: intensive blood pressure control and drugs reduce morbidity and mortality in hypertension and diabetes mellitus

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 QUESTION: In patients with hypertension and diabetes mellitus, what is the effectiveness of various antihypertensive treatments?

Data sources

Studies were identified by searching Medline (to June 1999) with the terms diabetes mellitus, hypertension, blood pressure, treatment, and therapy. Bibliographies of relevant studies were also checked.

Study selection

English language studies were selected if they were randomised controlled trials of >12 months duration that compared the effects of active drug treatments with placebo on morbidity and mortality in patients with hypertension and diabetes mellitus.

Data extraction

Data were extracted on patient characteristics, follow up period, blood pressure, rate of patients continuing to receive monotherapy, and cardiovascular morbidity and mortality.

Main results

8 studies (5244 patients) met the selection criteria. 3 studies compared 2 active treatments, 1 study reported …

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  • Sources of funding: various pharmaceutical companies.

  • For correspondence: Dr F H Messerli, Ochsner Clinic, 1514 Jefferson Highway, New Orleans, LA 70121, USA. Fax +1 504 842 4220.