Blood Pressure Lowering in Type 2 Diabetes: A Systematic Review and Meta-analysis

This analysis of 40 RCTs (n=100,354) found that each 10mmHg reduction in systolic BP was associated with a lower risk of mortality (absolute risk reduction of 3.16 events per 1000 patient years), CV events (3.90), CHD events (1.81) and stroke (4.06) in people with type 2 diabetes

Current NICE guidance on type 2 diabetes recommends a BP target of 140/80 mmHg (or 130/80 mmHg if there is kidney, eye or cerebrovascular disease). 

 

As well as the stated reductions in mortality, CHD events, CVD events and stroke, each 10mmHg reduction in systolic BP was also associated with a reduction in retinopathy and albuminuria. An accompanying comment states that younger patients who have not yet developed diabetic complications would tolerate BP lowering to 130/80mm Hg or lower more successfully than older patients, and that it would therefore seem appropriate to consider a “bolder approach” in such patients, especially those with albuminuria or other early manifestations of microvascular or macrovascular disease.