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Cited by 6Blood Pressure and Hypertension StudiesDiabetes, Cardiovascular Risks, and LipoproteinsDiabetes Treatment and Management

Association between difference in blood pressure reduction and risk of cardiovascular events in a type 2 diabetes population: a meta-regression analysis

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Grenet, G., Le, H.H., Bejan-Angoulvant, T., Erpeldinger, S., Boussageon, R., Kassaï, B., Moulin, P., Gueyffier, F. +1 more·2019·Diabetes & Metabolism
DOI 10.1016/j.diabet.2019.05.003
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Abstract

AIM: Recent US recommendations indicate a target blood pressure (BP) of 130/80mmHg for patients with type 2 diabetes (T2D). Our aim was to characterize the association between risk of cardiovascular events and differences in BP decreases in randomized trials of a T2D population. METHODS: A systematic search was made for randomized clinical trials assessing the effects of antihypertensive treatments in T2D patients on mortality, and fatal and non-fatal cardiovascular events, using a meta-regression technique to explore the influence of BP decreases on treatment effects. RESULTS: A total of 88,503 patients from 44 randomized trials were included. There was no significant association between BP decreases and risk of all-cause or cardiovascular mortality, cardiovascular events or myocardial infarction. However, stroke risk was influenced by BP decreases: compared with no reduction, a 10-mmHg reduction in systolic BP was associated with a relative odds ratio (OR) decrease of 33% (OR: 0.67, 95% CI: 0.54-0.82), and a 5-mmHg diastolic BP reduction was associated with a relative OR decrease of 38% (OR: 0.62, 95% CI: 0.50-0.76). Restricting the analysis to double-blind studies did not change the results for diastolic BP. CONCLUSION: A reduction in BP lowers the risk of stroke, but does not appear to affect the risk of other cardiovascular events in a T2D population.

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  • More intensive blood-pressure control (≤130 mmHg) was associated with a greater reduction in stroke but did not reduce other events.

    “whereas more intensive BP control (≤130 mmHg) was associated with a greater reduction in stroke but did not reduce other events.194,195”

    From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [195]

  • In a meta-analysis of randomized controlled trials involving patients with diabetes or prediabetes, systolic blood pressure reduction to ≤135 mmHg compared with less intensive control reduced the relative risk of all-cause mortality by 10% (OR 0.90; 95% CI, 0.83-0.98).

    “In a meta-analysis of RCTs involving patients with diabetes or prediabetes, an SBP reduction to ≤135 mmHg compared with a less intensive control reduced the RR of all-cause mortality by 10% (odds ratio [OR] 0.90; 95% CI, 0.83-0.98)”

    From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [195]

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Authors
Grenet, G., Le, H. H., Bejan-Angoulvant, T., Erpeldinger, S., Boussageon, R., Kassaï, B., Moulin, P., Gueyffier, F., & Cucherat, M.
Affiliations
  • Lyon 1 Université (FR)
  • Université de Poitiers (FR)
Corresponding author
Grenet, G.
ORCID
Venue
Diabetes & Metabolism
Publisher
Elsevier BV
Published
2019-12
Volume
45
Issue
6
Pages
550-556
ISSN
1262-3636 (ISSN-L)
DOI
10.1016/j.diabet.2019.05.003
OpenAlex
W2947950721
Cited by
6
References
34
Citations by year
2024: 1 · 2023: 3 · 2021: 2
FWCI
0.36
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes & Metabolism (acceptedVersion, other-oa)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, cc-by-nc)
Funders
  • Amgen
  • Eli Lilly and Company
  • AstraZeneca
  • Sanofi
  • Les Laboratories Pierre Fabre
  • Novo Nordisk
  • Université Claude Bernard Lyon 1
  • Servier
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
type 2 diabetes, blood pressure reduction, antihypertensive therapy, cardiovascular events, stroke, cardiovascular mortality, myocardial infarction, systolic blood pressure, diastolic blood pressure, blood pressure targets
MeSH terms
Antihypertensive Agents, Blood Pressure, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Humans, Hypertension, Myocardial Infarction, Regression Analysis, Risk Factors, Randomized Controlled Trials as Topic, Stroke

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