When associated with high blood pressure, type 2 diabetes mellitus is characterised by a high risk of adverse cardiovascular (CV) and renal outcomes. However, both can be effectively reduced by antihypertensive treatment. Current guidelines on the treatment of hypertension emphasize the need to effectively treat high blood pressure in diabetic individuals, but their recommendations differ in terms of the optimal target blood pressure value to aim for in order to maximise CV and renal protection. In some guidelines the recommended target blood pressure values are <140/90 mmHg (systolic/diastolic), whereas in others, blood pressure values close or even less than 130/80 mmHg are recommended. This paper will discuss the evidence for and against a conservative or more aggressive blood pressure target for treated diabetic hypertensive individuals based on the evidence provided by randomised trials, trial meta-analyses and large observational studies. Based on the available evidence, it appears that blood pressure targets will probably have to be lower than <140/90 mmHg, and that values approaching 130/80 mmHg should be recommended. However, evidence in favour of even lower systolic values, i.e. <130 mmHg, is limited and is definitively against a reduction to <120 mmHg.

Mancia, G., Grassi, G. (2018). Blood pressure targets in type 2 diabetes. Evidence against or in favour of an aggressive approach. DIABETOLOGIA, 61(3), 517-525 [10.1007/s00125-017-4537-3].

Blood pressure targets in type 2 diabetes. Evidence against or in favour of an aggressive approach

Mancia, Giuseppe
Primo
;
Grassi, Guido
Ultimo
2018

Abstract

When associated with high blood pressure, type 2 diabetes mellitus is characterised by a high risk of adverse cardiovascular (CV) and renal outcomes. However, both can be effectively reduced by antihypertensive treatment. Current guidelines on the treatment of hypertension emphasize the need to effectively treat high blood pressure in diabetic individuals, but their recommendations differ in terms of the optimal target blood pressure value to aim for in order to maximise CV and renal protection. In some guidelines the recommended target blood pressure values are <140/90 mmHg (systolic/diastolic), whereas in others, blood pressure values close or even less than 130/80 mmHg are recommended. This paper will discuss the evidence for and against a conservative or more aggressive blood pressure target for treated diabetic hypertensive individuals based on the evidence provided by randomised trials, trial meta-analyses and large observational studies. Based on the available evidence, it appears that blood pressure targets will probably have to be lower than <140/90 mmHg, and that values approaching 130/80 mmHg should be recommended. However, evidence in favour of even lower systolic values, i.e. <130 mmHg, is limited and is definitively against a reduction to <120 mmHg.
Articolo in rivista - Review Essay
Antihypertensive treatment; Blood pressure targets; Cardiovascular events; Cardiovascular morbidity; Cardiovascular mortality; Diabetes mellitus; Review;
Antihypertensive treatment; Blood pressure targets; Cardiovascular events; Cardiovascular morbidity; Cardiovascular mortality; Diabetes mellitus; Review; Internal Medicine; Endocrinology, Diabetes and Metabolism
English
2018
61
3
517
525
open
Mancia, G., Grassi, G. (2018). Blood pressure targets in type 2 diabetes. Evidence against or in favour of an aggressive approach. DIABETOLOGIA, 61(3), 517-525 [10.1007/s00125-017-4537-3].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/184084
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