Blood pressure targets for hypertension in people with diabetes mellitus

Arguedas, José Agustín; Leiva, Viriam; Wright, James M

doi:10.1002/14651858.cd008277.pub2

Cited by 77 publications

(52 citation statements)

References 52 publications

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“…At the present time, evidence from RCTs does not support BP targets lower than the standard targets in people with elevated BP and T2D [12]. On the contrary, taken altogether, available results rather suggest that T2D patients (<140 mm Hg or <130 mm Hg) and nondiabetic patients (<120 mm Hg) may require different systolic BP targets for optimal CV protection, although stroke and renal considerations should also influence the selection of BP targets [62].…”

Section: ) Trials With Different Bp Targets In Patients With T2dmentioning

confidence: 57%

“…It is noteworthy, however, that this interaction was not found in another meta-analysis focusing on patients at high CV risk, which rather showed a trend for slightly greater reduction in major cardiovascular events (MACEs) among patients with T2D versus patients without diabetes [10]. Finally, despite the well demonstrated benefit of lowering BP in diabetes [11], BP targets in patients with T2D [12] as well in patients with high CV risk [13] remain controverted, so that targets may vary between guidelines [14].…”

Section: Introductionmentioning

confidence: 92%

“…BP targets in patients with T2D are controverted because results from RCTs were heterogeneous [12]. In the Hypertension Optimal Treatment (HOT) trial, 18 790 patients were randomly assigned a target diastolic BP ≤ 80, ≤ 85 or ≤ 90 mm Hg [57].…”

Section: ) Trials With Different Bp Targets In Patients With T2dmentioning

confidence: 99%

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Effects of reducing blood pressure on cardiovascular outcomes and mortality in patients with type 2 diabetes: Focus on SGLT2 inhibitors and EMPA-REG OUTCOME

Scheen

2016

Diabetes Research and Clinical Practice

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Please cite this article as: A.J. Scheen, Effects of reducing blood pressure on cardiovascular outcomes and mortality in patients with type 2 diabetes: focus on SGLT2 inhibitors and EMPA-REG OUTCOME, Diabetes Research and Clinical Practice (2016), doi: http://dx.doi.org/10.1016/j.diabres. 2016.09.016 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. SummaryEmpagliflozin, a sodium-glucose cotransporter type 2 (SGLT2) inhibitor, has shown a remarkable reduction in cardiovascular and all-cause mortality in patients with type 2 diabetes (T2D) and antecedents of cardiovascular disease in the EMPA-REG OUTCOME trial. This effect has been attributed to a hemodynamic rather than a metabolic effect, partly due to the osmotic/diuretic effect of empagliflozin and to the reduction in arterial blood pressure. The present review will : 1) summarize the results of specific studies having tested the blood pressure lowering effects of SGLT2 inhibitors; 2) describe the results of meta-analyses of trials having evaluated the effects on mortality and cardiovascular outcomes of lowering blood pressure in patients with T2D, with a special focus on baseline and target blood pressures; 3) compare the cardiovascular outcome results in EMPA-REG OUTCOME versus other major trials with antihypertensive agents in patients with T2D; and 4) evaluate post-hoc analyses from EMPA-REG OUTCOME, especially subgroups of patients of special interest regarding the blood pressure lowering hypothesis. Although BP reduction associated to empagliflozin therapy may partly contribute to the benefits reported in EMPA-REG OUTCOME, other mechanisms most probably play a greater role in the overall CV protection and reduction in mortality observed in this trial.

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Section: ) Trials With Different Bp Targets In Patients With T2dmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 92%

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Effects of reducing blood pressure on cardiovascular outcomes and mortality in patients with type 2 diabetes: Focus on SGLT2 inhibitors and EMPA-REG OUTCOME

Scheen

2016

Diabetes Research and Clinical Practice

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“…Lost blood volume will be replaced osmotically from water held in body cells and other body compartments, causing dehydration and increased thirst (polydipsia). 26 Prevention: There is no known preventive measure for type 1 diabetes. Type 2 diabetes can often be prevented by a person being a normal body weight, physical exercise, and following a healthy diet.…”

Section: Gestational Diabetesmentioning

confidence: 99%

Diabetes Mellitus and Gestational Diabetes Mellitus

Begum

Afroz

Khanam

et al. 2015

J. paediatr. surg. Bangladesh

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Abstract:Diabetes mellitus (DM), also known as simply diabetes, is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period. Worldwide in 2012 and 2013 diabetes resulted in 1.5 to 5.1 million deaths per year, making it the 8th leading cause of death. Diabetes overall at least doubles the risk of death. This high blood sugar produces the symptoms of frequent urination, increased thirst, and increased hunger. Untreated, diabetes can cause many complications. Acute complications include diabetic ketoacidosis and nonketotic hyperosmolar coma. Serious long-term complications include heart disease, stroke, kidney failure, foot ulcers and damage to the eyes. The number of people with diabetes is expected to rise to 592 million by 2035. The economic costs of diabetes globally were estimated in 2013 at $548 billion and in the United States in 2012 $245 billion. [3] Globally, as of 2013, an estimated 382 million people have diabetes worldwide, with type 2 diabetes making up about 90% of the cases. This is equal to 8.3% of the adults' population, with equal rates in both women and men. There are three main types of diabetes mellitus: In case of type 1 Diabetes mellitus, results from the body's failure to produce enough insulin. This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes". The cause is unknown. Another type is type 2 diabetes mellitus begins with insulin resistance, a condition in which cells fail to respond to insulin properly. As the disease progresses a lack of insulin may also develop. This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes". The primary cause is excessive body weight and not enough exercise. Gestational diabetes is the third main form and occurs when pregnant women without a previous history of diabetes develop a high blood glucose level. Gestational diabetes usually resolves after the birth of the baby. It occurs in about 2-10% of all pregnancies and may improve or disappear after delivery. However, after pregnancy approximately 5-10% of women with gestational diabetes are found to have diabetes mellitus, most commonly type 2. Gestational diabetes is fully treatable, but requires careful medical supervision throughout the pregnancy.

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“…High blood pressure (hypertension) and diabetes mellitus are two major risk factors for cardiovascular disease, which is increasing rapidly in Africa and worldwide [1] [2]. Africa has the highest prevalence rate of hypertension in the world, with 46% of adults over the age of 25 with [3].…”

Section: Introductionmentioning

confidence: 99%

Epidemiological, Clinical and Therapeutic Characteristics of Hypertensive Type 2 Diabetics at the Marc Sankale Center of Dakar

Sow¹,

Diédhiou²,

Diallo³

et al. 2018

OJEMD

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Introduction: High blood pressure (hypertension) and diabetes mellitus are two major risk factors for cardiovascular disease, which is increasing rapidly in Africa and worldwide. Africa has the highest prevalence rate of hypertension in the world, with 46% of adults over the age of 25 with. Hypertension is common in type 2 diabetes and increases cardiovascular risk. The association of these two pathologies has many particularities in the sub-Saharan subject. The work related to this entity in Africa shows a frequency between 30% and 60%. The objective was to describe the epidemiological, clinical and therapeutic characteristics at the Medical Clinic II of the Abass Ndao Hospital Center in Dakar. Patients Methods: This was a cross-sectional, descriptive and analytical study conducted from 01 December 2016 to 31 January 2017. It focused on patients with cardiothyrosis. Epidemiological data, cardiovascular risk factors, and cardiothoracic characteristics were evaluated. Results: 303 cases were recorded with a prevalence of 42%, an average age of 61.63 years, a sex ratio of 0.22. The age group of [60 -70] years was the most representative at 36.30%. The BMI (Body Mass Index) average was 27.06 kg/m². Obesity was 25% and 35% were overweight. Dyslipidemia consisting of an increase in LDL cholesterol > 1 g/l in 79%, a hypercholesterolemia in 57%, a decrease in HDL cholesterol in 13.23% and a hypertriglyceridemia in 28%. Patients with three cardiovascular risk factors accounted for 93.72%. The average fasting glucose level was 2.85 g/l. Hyperglycemia was noted in 65%. The glycosylated hemoglobin is greater than 7% in 47%. The duration of diabetes was less than 5 years

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Blood pressure targets for hypertension in people with diabetes mellitus

Abstract: Blood pressure targets for hypertension in people with diabetes mellitus.

Cited by 77 publications

References 52 publications

Effects of reducing blood pressure on cardiovascular outcomes and mortality in patients with type 2 diabetes: Focus on SGLT2 inhibitors and EMPA-REG OUTCOME

Effects of reducing blood pressure on cardiovascular outcomes and mortality in patients with type 2 diabetes: Focus on SGLT2 inhibitors and EMPA-REG OUTCOME

Diabetes Mellitus and Gestational Diabetes Mellitus

Epidemiological, Clinical and Therapeutic Characteristics of Hypertensive Type 2 Diabetics at the Marc Sankale Center of Dakar

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