Appropriate blood pressure control in hypertensive and normotensive type 2 diabetes mellitus: a summary of the ABCD trial

Schrier, Robert W.; Estacio, Raymond O.; Mehler, Philip S.; Hiatt, William R.

doi:10.1038/ncpneph0559

Cited by 113 publications

(66 citation statements)

References 41 publications

(15 reference statements)

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“…Clinical trials have previously shown that a high BP increases the risk of CVEs (especially stroke) and all-cause mortality in patients with type 2 diabetes [23,24]. However, in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) BP study in patients with nearly to normal renal function, a target SBP of ≤120 mmHg did not reduce the risk of major CVE compared with a SBP of ≤140 mmHg [10].…”

Section: Discussionmentioning

confidence: 80%

Blood pressure level and risk of major cardiovascular events and all-cause of mortality in patients with type 2 diabetes and renal impairment: an observational study from the Swedish National Diabetes Register

et al. 2015

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Aims/hypothesis We assessed the relationship between BP and risk of cardiovascular events (CVEs) and all-cause mortality in patients with type 2 diabetes and renal impairment (estimated GFR<60 ml min −1 1.73 m −2 ) treated in clinical practice. Methods A total of 33,356 patients (aged 75±9 years, diabetes duration of 10±8 years) with at least one serum creatinine and BP value available in the Swedish National Diabetes Register between 2005 and 2007 were followed up until 2011 or death. The relationships between mean BPs, CVEs and all-cause mortality were examined using time-dependent Cox models to estimate HRs, adjusting for cardiovascular risk factors and ongoing medications. Conclusions/interpretation In this nationwide cohort of patients with type 2 diabetes and renal impairment, the risk of CVEs and all-cause mortality increased significantly with both high and low BPs, while an SBP of 135-139 mmHg and DBP of 72-74 mmHg were associated with the lowest risks of CVEs and death.

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Section: Discussionmentioning

confidence: 80%

Blood pressure level and risk of major cardiovascular events and all-cause of mortality in patients with type 2 diabetes and renal impairment: an observational study from the Swedish National Diabetes Register

et al. 2015

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“…Several factors are known to slow the rate of urinary albumin excretion or to prevent its development. They include reducing blood pressure (with a blocker of the renin angiotensin system as part of the regimen), glycemic control, and lipid-lowering therapy (45,(343)(344)(345).…”

Section: Laboratory Analysis Of Diabetesmentioning

confidence: 99%

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

et al. 2011

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BACKGROUND Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially. APPROACH An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. Draft guidelines were posted on the Internet and presented at the 2007 Arnold O. Beckman Conference. The document was modified in response to oral and written comments, and a revised draft was posted in 2010 and again modified in response to written comments. The National Academy of Clinical Biochemistry and the Evidence Based Laboratory Medicine Committee of the AACC jointly reviewed the guidelines, which were accepted after revisions by the Professional Practice Committee and subsequently approved by the Executive Committee of the American Diabetes Association. CONTENT In addition to long-standing criteria based on measurement of plasma glucose, diabetes can be diagnosed by demonstrating increased blood hemoglobin A1c (Hb A1c) concentrations. Monitoring of glycemic control is performed by self-monitoring of plasma or blood glucose with meters and by laboratory analysis of Hb A1c. The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed. SUMMARY The guidelines provide specific recommendations that are based on published data or derived from expert consensus. Several analytes have minimal clinical value at present, and their measurement is not recommended.

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“…The association between diabetes and hemorrhagic stroke is controversial. 3,4,13 However, diabetes often coexists with hypertension, 14 which has been reported to have an association with cerebral hemorrhage. 15 The aim of the present study is to investigate the relationship between the incidence of ischemic and hemorrhagic stroke and hyperglycemia and to compare the differences between fasting and 2-hour plasma glucose criteria.…”

mentioning

confidence: 99%

Hyperglycemia and Incidence of Ischemic and Hemorrhagic Stroke-Comparison Between Fasting and 2-Hour Glucose Criteria

Hyvärinen

Tuomilehto

Mähönen

et al. 2009

Stroke

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for the DECODE Study GroupBackground and Purpose-We examined the impact of hyperglycemia on ischemic and hemorrhagic stroke incidence comparing criteria based on fasting plasma glucose (FPG) and 2-hour plasma glucose (2-hour PG). Methods-Data from 9 European cohorts comprising 18 360 individuals between 25 to 90 years of age were collaboratively analyzed. The maximum length of follow-up varied between 4.9 to 36.8 years. Hazards ratios (95% confidence intervals) for stroke incidence were estimated using Cox-proportional hazards model adjusting for known risk factors. Results-In individuals without a prior history of diabetes, the multivariate-adjusted hazards ratio for ischemic stroke corresponding to 1 SD increase in FPG was 1.12 (1.02 to 1.22) and in 2-hour PG 1.14 (1.05 to 1.24). Adding 2-hour PG to the model with FPG significantly improved the prediction of the model for the incidence of ischemic stroke ( 2 ϭ4.72, Pϭ0.03), whereas FPG did not improve the 2-hour PG model prediction ( 2 ϭ0.25, Pϭ0.62). A significantly increased hazard ratio was also observed for previously diagnosed diabetes (2.26 [1.51 to 3.38]) and for screen-detected diabetes defined by FPG (1.48 [1.08 to 2.02]) and 2-hour PG (1.60 [1.18 to 2.16]). None of the criteria predicted hemorrhagic stroke. Conclusions-Diabetes defined by either of the criteria predicted the future risk of ischemic stroke but not the hemorrhagic stroke. The prediction is stronger for elevated 2-hour PG than for FPG levels.

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Appropriate blood pressure control in hypertensive and normotensive type 2 diabetes mellitus: a summary of the ABCD trial

Cited by 113 publications

References 41 publications

Blood pressure level and risk of major cardiovascular events and all-cause of mortality in patients with type 2 diabetes and renal impairment: an observational study from the Swedish National Diabetes Register

Blood pressure level and risk of major cardiovascular events and all-cause of mortality in patients with type 2 diabetes and renal impairment: an observational study from the Swedish National Diabetes Register

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

Hyperglycemia and Incidence of Ischemic and Hemorrhagic Stroke-Comparison Between Fasting and 2-Hour Glucose Criteria

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