More-Intense Blood Pressure Treatment Lowers Heart Risks
What to Know
More people with type 2 diabetes die from heart disease than from any other complication, and the leading cause of heart disease is high blood pressure (hypertension). The clear prescription: Keep your blood pressure down to lower your risk of an early death. But experts disagree on how best to control it. The American Diabetes Association recommends a systolic (top number) blood pressure below 140. This study investigated whether more-intense control of high blood pressure was the ideal approach for people with type 2 diabetes and an elevated risk of heart disease.
Researchers evaluated data from 1,284 people with type 2 diabetes who had participated in a previous blood pressure study in which they were followed for an average of four years. Their average age was 64; most were men. All of them had a heightened risk of having a heart attack. Half of the participants received intensive blood pressure treatment designed to bring their systolic blood pressure to 120 or below. That meant they were prescribed more and/or stronger medications than the other participants, who received standard treatment, the goal of which was to keep their systolic blood pressure below 140. The researchers then evaluated the participants’heart health outcomes to see if either group did better than the other.
The participants who received intense treatment had an average systolic blood pressure of 120 by the end of the study, while the other group averaged 134. Compared with standard care, intense treatment lowered by 21 percent the combined risk of dying of heart disease, having a nonfatal heart attack or stroke, having surgery to repair blood vessel function, or developing heart failure. However, 4 percent of those receiving intense treatment reported serious side effects due to their medications compared with 2 percent of the standard treatment group. Those side effects included low blood pressure, fainting, an abnormal heartbeat, and kidney failure.
An estimated 25 percent of people with type 2 diabetes have an elevated risk of heart attack. If you are one of them, you and your heart may benefit from more-intense blood pressure treatment. However, the authors note that their study is not definitive. Such treatment should be handled with care by your physician, especially if you’re already undergoing intensive blood glucose control. Talk to your doctor before making any changes to your treatment plan.
“Intensive Versus Standard Blood Pressure Control in SPRINT Eligible Participants of the ACCORD-BP Trial.” Leo F. Buckley, Dave L. Dixon, George F. Wohlford IV, Dayanjan S. Wijesinghe, William L. Baker, and Benjamin W. Van Tassell. Diabetes Care, published online Sept. 25, 2017.