Effects of Intensive Blood Pressure Reduction on Myocardial Infarction and Stroke in Diabetes: A Meta-Analysis in 73,913 Patients

Reboldi, Gianpaolo; Gentile, Giorgio; Angeli, Fabio; Ambrosio, Giuseppe; Mancia, G.; Verdecchia, Paolo

doi:10.1097/00004872-201106001-00282

Cited by 196 publications

(88 citation statements)

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“…The seventh report of the Joint National Committee on BP estimated that a systolic BP reduction of at least 5 mm Hg (similar to the observed decline in SBP after Lycopene supplementation) could decrease the risk of mortality due to stroke by 13-14% [37,38] and mortality from cardiovascular diseases by 9% [37]. In addition, reductions of 1 mmol in LDL-cholesterol have been associated with a 23% reduction in myocardial infarction or coronary death and 12% reduction in all-cause mortality [39].…”

Section: Implications For Health and Future Researchmentioning

confidence: 90%

Tomato and lycopene supplementation and cardiovascular risk factors: A systematic review and meta-analysis

et al. 2017

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Section: Implications For Health and Future Researchmentioning

confidence: 90%

Tomato and lycopene supplementation and cardiovascular risk factors: A systematic review and meta-analysis

et al. 2017

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“…No entanto, uma reavaliação recente das evidências disponíveis (71,96) demonstrou que nenhum dos ensaios clínicos aleatórios de tratamento anti--hipertensivo em diabéticos com hipertensão levou a uma média de valores de PAS abaixo de 130 mmHg, e o estudo recente Action to Control Cardiovascular Risk in Diabetes (ACCORD) (97) não mostrou nenhuma redução adicional dos eventos cardiovasculares, e ainda foi observada uma maior incidência de efeitos adversos nos pacientes diabéticos aleatorizados para alcançar uma PAS < 120 mmHg em comparação com aqueles aleatorizados para alcançar uma PAS < 140 mmHg (os valores médios realmente alcançados foram de 119 mmHg e 133 mmHg). Uma série de recentes metanálises (98,99) dirigidas para correlacionar os eventos cardiovasculares com a PA obtida não encontrou nenhum benefício adicional ou piora na incidência de eventos cardiovasculares quando a pressão arterial alcançada era mais baixa, com a possível exceção da incidência de acidentes cerebrovasculares (99). Na realidade, parece que em pacientes hipertensos com diabetes o objetivo de PAS < 140 mmHg deve ser recomendado assim como nos não diabéticos hipertensos.…”

Section: Tratamento Farmacológicounclassified

Latin American consensus on hypertension in patients with diabetes type 2 and metabolic syndrome

López‐Jaramillo

Sánchez

Díaz³

et al. 2013

Journal of Hypertension

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“…regardless of how it is attained [6]. On the other hand, the blood pressure level that needs to be achieved in order to maximise the CV protection of hypertensive individuals with diabetes is uncertain.…”

Section: Introductionmentioning

confidence: 99%

Blood pressure targets in type 2 diabetes. Evidence against or in favour of an aggressive approach

Mancia

2018

Diabetologia

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When associated with high blood pressure, type 2 diabetes mellitus is characterised by a high risk of adverse cardiovascular (CV) and renal outcomes. However, both can be effectively reduced by antihypertensive treatment. Current guidelines on the treatment of hypertension emphasize the need to effectively treat high blood pressure in diabetic individuals, but their recommendations differ in terms of the optimal target blood pressure value to aim for in order to maximise CV and renal protection. In some guidelines the recommended target blood pressure values are <140/90 mmHg (systolic/diastolic), whereas in others, blood pressure values close or even less than 130/80 mmHg are recommended. This paper will discuss the evidence for and against a conservative or more aggressive blood pressure target for treated diabetic hypertensive individuals based on the evidence provided by randomised trials, trial meta-analyses and large observational studies. Based on the available evidence, it appears that blood pressure targets will probably have to be lower than <140/90 mmHg, and that values approaching 130/80 mmHg should be recommended. However, evidence in favour of even lower systolic values, i.e. <130 mmHg, is limited and is definitively against a reduction to <120 mmHg.

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Effects of Intensive Blood Pressure Reduction on Myocardial Infarction and Stroke in Diabetes: A Meta-Analysis in 73,913 Patients

Cited by 196 publications

References 0 publications

Tomato and lycopene supplementation and cardiovascular risk factors: A systematic review and meta-analysis

Tomato and lycopene supplementation and cardiovascular risk factors: A systematic review and meta-analysis

Latin American consensus on hypertension in patients with diabetes type 2 and metabolic syndrome

Blood pressure targets in type 2 diabetes. Evidence against or in favour of an aggressive approach

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