Lower Blood Pressure Targets in Type 2 Diabetes (June 2025). Medscape.
Lower Blood Pressure Targets in Type 2 Diabetes (June 2025). Medscape.
1. Study Overview
• Large randomized trial conducted in China with over 12,000 patients >50 years old, all with type 2 diabetes and high cardiovascular risk.
• Aim: Compare intensive systolic BP control (<120 mmHg) vs standard control (<140 mmHg).
2. Primary Outcomes Tracked
• Nonfatal stroke
• Nonfatal myocardial infarction (MI)
• Hospitalization for heart failure
• Cardiovascular death
3. Key Results
• Mean follow-up: ~4 years
• Significant reduction in primary cardiovascular outcomes in the intensive group.
• Outcomes began to diverge after about 1 year of treatment.
4. Blood Pressure Findings
• Mean BP achieved:
• Intensive group: 121.6 mmHg
• Standard group: 133.2 mmHg
• Difference (~12 mmHg) was associated with clear outcome benefit.
5. Study Design Highlights
• BP measured using standardized protocol:
• No caffeine, smoking, or exercise 30 mins prior
• 5-minute rest
• 3 silent readings, 1 minute apart
• Average of 3 readings used to guide treatment.
6. Medication Use & Safety
• Intensive group required 1–2 more medications on average.
• No major difference in serious adverse events.
• Increased rates of symptomatic hypotension and hyperkalemia in intensive group.
7. Clinical Implication
• The author (Dr. Anne Peters) notes this has changed her practice, now targeting systolic BP closer to 120 mmHg for eligible patients.
• Suggests tighter BP control may lead to better cardiovascular protection, if tolerated.
8. Conclusion
• The trial may influence future guidelines.
• Lowering systolic BP below 130 mmHg—and ideally closer to 120—could provide added benefit for patients with type 2 diabetes and high CV risk.