February 04, 2020 Intensive blood pressure therapy may lower death risk in type 2 diabetes

According to a study published in the American Heart Association’s journal Hypertension,

People with type 2 diabetes who received intensive treatment to keep their blood pressure levels at 130/80 mm/Hg or below had fewer heart attacks, strokes, and other diabetes complications compared to those who did not get intensive treatment.

A research team with the ADVANCE (Action in Diabetes and Vascular Disease) trial looked at data for 11,000 people at 215 clinical centres in 20 countries. Everyone in the study had type 2 diabetes and high blood pressure. Half received a combination of drugs (perindopril and indapamide) to keep their blood pressure levels at 130/80 mm/Hg or below. The other half received a placebo (a drug with no active ingredient).

Over the four-year study, more than 800 deaths and 950 major vascular events—including heart attacks, strokes, diabetic kidney disease, and diabetic eye disease—occurred. Among people who got the combination of drugs, there were 14 per cent fewer deaths and nine per cent fewer vascular events than among the people who took the placebo.

The study’s conclusion supports the Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada, which recommends in the Treatment of Hypertension chapter that people with diabetes should be treated to achieve a blood pressure of less than 130/80 mmHg.

(This article appeared in Diabetes Dialogue, Winter 2020)