Should we change the target blood pressure in diabetic patients?
Article first published online: 28 DEC 2012
Copyright © 2012 John Wiley & Sons, Ltd.
Diabetes/Metabolism Research and Reviews
Special Issue: Proceedings of the 1st Asia Pacific Congress on Controversies to Consensus in Diabetes, Obesity and Hypertension (CODHy), June 2-5, 2011, Shanghai, China. The 1st Asia Pacific Congress on Controversies to Consensus in Diabetes, Obesity and Hypertension (CODHy) and Wiley have published this supplement without financial support.
Volume 28, Issue Supplement s2, pages 1–7, December 2012
How to Cite
Shlomai, G. and Grossman, E. (2012), Should we change the target blood pressure in diabetic patients?. Diabetes Metab. Res. Rev., 28: 1–7. doi: 10.1002/dmrr.2348
- Issue published online: 28 DEC 2012
- Article first published online: 28 DEC 2012
- Received: 7 November 2011 Accepted: 28 February 2012
- diabetes mellitus;
- target blood pressure;
Hypertension is a major modifiable risk factor for cardiovascular morbidity and mortality in diabetic patients. Guidelines recommend lowering blood pressure (BP) to less than 130/80 mmHg in diabetic patients. These recommendations are based on several studies in diabetic patients that showed the benefit of intensive BP control. However in all the studies the achieved BP was higher than 130/80 mmHg. Re-evaluation of earlier studies, as well as more recently accumulated data suggest that intensive BP control is associated with a significant reduction in all-cause mortality and stroke rate, but with no benefit for other microvascular or macrovascular (cardiac, renal and retinal) outcomes. Intensive BP control is associated with an increased risk of serious adverse effects, particularly for systolic BPs levels lower than 130 mmHg. When determining the target BP in diabetic patients one should balance the potential cerebrovascular protection against the increased risk of serious side effects, and the absence of benefit for other circulatory system. It seems therefore, that lowering BP to levels close to 130/80 mmHg should be the main goal of treatment in diabetic patients.