Tackling high BP early reduces risk in diabetes

Treating recent-onset hypertension earlier can greatly lower the risk of MI and stroke in patients with diabetes, US research suggests.

Stroke: patients with high BP faced higher risk of cardiovascular event (photo:SPL)
Stroke: patients with high BP faced higher risk of cardiovascular event (photo:SPL)

Patients without adequate BP control one year after the onset of hypertension were found to have a 30% higher risk of a major cardiovascular event within three years.

Researchers from the Health Partners Research Foundation in Minnesota said the findings strengthened the idea that BP control should be a key short-term clinical goal in people with hypertension.

They said the results 'suggest that insufficient attention has been devoted to the aggressive early management of BP in patients with diabetes'.

The researchers looked at clinical data from 15,665 middle-aged adults with diabetes, all of whom had recent-onset hypertension. Mean BP was 136.8/80.8mmHg at onset and fell to 131.4/80.8mmHg within one year.

By this time, BP was well controlled (below 130/80mmHg)in 32.9% of patients, but poorly controlled (above 140/90mmHg) in 19.8% of patients. The researchers examined rates of cardiovascular events within these groups after three years. Events included MI and haemorrhagic, thrombotic and ischaemic stroke.

Among those with BP of less than 130/80mmHg one year after onset, there were 5.1 cases of major cardiovascular disease per 1,000 person-years. This compared with 6.9 events per 1,000 person-years among those with BP over 140/90mmHg.

Researchers said this equated to a 30% higher risk of a cardiovascular event among patients with BP over 140/90mmHg. The risk was raised for MI, haemorrhagic stroke and thrombotic stroke, but not ischaemic stroke.Owing to the observational nature of the study, they could not confirm a causal link between early intervention and risk reduction. Nevertheless, they concluded: 'Prompt identification and control of hypertension in patients with diabetes may provide very important short-term clinical benefits.'

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