Type 2 diabetes patients who are on blood pressure-lowering drugs were found to have a lower risk of cardiovascular disease and a longer life expectancy.
Patients with type 2 diabetes have a significantly higher rate of major health events such as heart attack and stroke, JAMA reported. These individuals also tend to have higher blood pressure (BP) than those who do not suffer from the condition.
Researchers conducted large-scale randomized controlled trials of BP-lowering treatment in diabetes patients, and found they came with significant health benefits.
"Among patients with type 2 diabetes, BP lowering was associated with improved mortality and other clinical outcomes. These findings support the use of medications for BP lowering in these patients," the researchers wrote.
The study included reviews of 40 trials encompassing 100,354 participants. The team found that each 10 mm Hg lower systolic BP came with a decreased risk of "mortality, cardiovascular disease events, coronary heart disease events, stroke, albuminuria (the presence of excessive protein in the urine), and retinopathy (loss of vision related to diabetes)" in these patients.
The association between the medications and patient outcomes were diminished below a BP level of 140 mm Hg, but the research showed a reduction in BP below 130 mm Hg is associated with a lower risk of "stroke, retinopathy, and albuminuria," the researchers reported.
"These findings are timely, clear, and important and lend support to current guideline recommendations to consider offering patients with type 2 diabetes antihypertensive therapy when their systolic BP is 140 mm Hg or greater, aiming for a target systolic BP toward 130 mm Hg but not usually lower than this," Dr. Bryan Williams, of University College London, wrote in an accompanying editorial.
The researcher noted the findings suggest these treatment thresholds could be too "conservative" for some patients in reducing the risk of stroke and albuminuria.
"This conundrum highlights the problems with clinician overreliance on guidelines and guideline overdependence on an often, uncritical adoption of evidence, despite the limitations of the clinical trials. Guidelines are just that, and are necessarily conservative in providing population-based recommendations that physicians must interpret in the context of the individual patient being treated," Williams concluded.
The findings were published in the Feb. 10 issue of JAMA.
