Blood pressure lowering in type 2 diabetics associated with improved mortality

While it is accepted that hypertension in diabetics should be treated, there is controversy about when to start treatment and the optimum blood pressure (BP) target.

Strong support for the “lower is better” hypothesis is provided by a meta-analysis published in JAMA (online, 10 February 2015)^[1]
. The analysis of more than 100,000 patients with type 2 diabetes, who participated in 40 randomised placebo-controlled trials, found that a 10mmHg reduction in systolic BP was associated with significant reductions in death, macrovascular events and microvascular events, with relative risk reductions ranging from 11% to 27%.

The analysis also suggested that lowering BP to below 130mmHg may further reduce the risk of stroke, retinopathy and albuminuria. “These findings support the use of medications for BP lowering in these patients,” the authors conclude.