Why the study?
Does tight control of blood pressure prevent macrovascular and microvascular complications in hypertensive patients with type 2 diabetes?
Population
Hypertensive patients with type 2 diabetes (mean age 56, mean blood pressure at entry 160/94 mm Hg)
Comparison
Tight control of blood pressure aiming at… vs Less tight control aiming at a blood pressure of…
Design
RCT, Stratified randomisation according to previous antihypertensive treatment
Follow-up
median 8.4 years
Key result
Tight blood pressure control reduced the risk of any diabetes-related endpoint by 24% compared to less tight control in patients with type 2 diabetes.
Authors
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Tight BP control should be prioritized in hypertensive type 2 diabetes; reinforces consensus on macrovascular and microvascular risk reduction.
RCT (n=1,148)
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Yes
Does tight control of blood pressure prevent macrovascular and microvascular complications in hypertensive patients with type 2 diabetes?
Tight blood pressure control in patients with hypertension and type 2 diabetes achieves a clinically important reduction in the risk of diabetes-related deaths, macrovascular complications like stroke, and microvascular complications.
Effect estimate: RR 0.76 (95% CI 0.62-0.92)
Absolute Event Rate: 11% vs 14%
p-value: p=0.0046
UK Prospective Diabetes Study Group (1998) conducted an RCT in Type 2 diabetes (n=1,148). Captopril or Atenolol vs. Less tight control aiming at < 180/105 mm Hg was evaluated on Any clinical end point related to diabetes (fatal and non-fatal) (RR 0.76, 95% CI 0.62-0.92, p=0.0046). Tight blood pressure control reduced the risk of any diabetes-related endpoint by 24% compared to less tight control in patients with type 2 diabetes.