Aggressive BP control can boost CV risk in diabetes

Aggressive BP lowering could increase the risk of cardiovascular events among patients with type-2 diabetes, an international study has found.

A subgroup analysis of the ONTARGET trial, involving 9,603 patients with type-2 diabetes who were followed up over four-and-a-half years, found that bringing BP below 130/80mmHg increased the risk of suffering an MI.

Lead researcher Professor Joseph Redon, from the University of Valencia, told delegates at the European Meeting of Hypertension that lowering BP in high-risk diabetic patients offered protection against stroke but did not protect against cardiac events.

'If your patient has more risk of a stroke you can go down to lower BPs with benefits,' he said. 'But if the patient has risk of coronary disease you have to be very careful of this, and you should not keep the BP too low.'

Professor Giuseppe Mancia, conference chairman and director of clinical medicine at Milan-Bicocca University, added: 'It is no longer true that the lower BP values are, the better it is for the patient.'

Professor Mancia recommended that elevated BP should be treated in otherwise risk-free individuals if it exceeds 140/90 mmHg.

sanjay.tanday@haymarket.com

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