Background: The ACCORD BP trial failed to show the benefit of strict blood pressure (BP) control on cardiovascular events in diabetics with high cardiovascular risk. However, this result cannot be generalized to all diabetics. We investigated whether lower mean BP in diabetic people with hypertension is associated with better prognosis. Methods: Participants from the Korea National Health Insurance Service Health Examinee Cohort who were diagnosed with diabetes and hypertension between 2003 and 2006 were included in the analysis (N¼7926). Mortality and cardiovascular events were compared among three groups according to mean SBP (<130, 130-<140, 140mmHg) and mean DBP (<80, 80-<90, 90mmHg) recorded during follow-up health examinations for up to 11 years. Results: Significant reductions in the risk of all-cause death, nonfatal myocardial infarction (MI), nonfatal stroke, and end-stage renal disease were observed in patients with a mean SBP of 130mmHg to less than 140mmHg, as compared with patients with a mean SBP of at least 140mmHg. The additional clinical benefit of a mean SBP of less than 130mmHg was unclear. Lower risk of all-cause death, cardiovascular mortality, and nonfatal strokes was observed in patients with a mean DBP of 80mmHg to less than 90mmHg. A mean DBP of less than 80mmHg was associated with further reduction in all-cause mortality, cardiovascular mortality, ischaemic stroke, and total stroke. Conclusion: A mean BP of less than 140/80mmHg was associated with further reduction in the risk of all-cause mortality, cardiovascular mortality, and nonfatal cardiovascular events in diabetic hypertensive patients.
Bibliographical noteFunding Information:
Source of funding: This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea (grant no. HI13C0715).
All Science Journal Classification (ASJC) codes
- Internal Medicine
- Cardiology and Cardiovascular Medicine