Is Intensive Blood Pressure Control Beneficial in High-Risk Patients?
Numerous clinical trials and epidemiologic analyses have established that lowering blood pressure reduces the risk for macrovascular and microvascular diseases among people with diabetes.[1] However, optimal systolic blood pressure (SBP) targets have not been agreed upon.
Buckley and colleagues[2] performed a post hoc analysis of ACCORD-BP participants who were in the standard glucose control arm and met inclusion criteria for SPRINT (additional cardiovascular disease [CVD] risk factors). The intensive SBP control arm (target < 120 mm Hg) was compared with the standard SBP control arm (< 140 mm Hg) on risk for a composite outcome of CVD death, nonfatal myocardial infarction (MI), nonfatal stroke, revascularization, and heart failure, as well as each of those components individually. Adverse events were also compared.
The main analysis focused on SPRINT-eligible ACCORD-BP participants, all of whom had diabetes. A secondary analysis pooled these people with actual SPRINT participants, none of whom had diabetes, to test whether the results differed between those with and those without diabetes.
Intensive Control Shows a Benefit
A total of 1284 individuals met inclusion criteria, about one half of whom (n = 652; 51%) were in the intensive SBP control arm.
