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Lower Systolic BP Is Tied to a Lower Risk of Future Cardiovascular Disease
- In patients with diabetes, those with low systolic blood pressure (BP; <120 mmHg) had a lower risk of future cardiovascular disease (CVD).
Why This Matters
- Findings extend the lower, the better paradigm of BP management in patients with diabetes and provide reassurance about the role of intensive BP lowering in this growing patient population.
- This was a prospective cohort study that included 49,000 patients with diabetes (age 50-90 years), identified using data from the UK Clinical Practice Research Datalink (1990-2005).
- Primary outcome: fatal or nonfatal CVD (composite of ischaemic heart disease, incident heart failure, stroke, and cardiovascular death).
- Secondary outcomes: individual components of the primary outcome, such as incident heart failure and stroke.
- Funding: British Heart Foundation and others.
- During a median follow-up of 7.3 years, 16,378 (33.4%) patients had cardiovascular events.
- Compared with patients with low systolic BP (<120 mmHg), the risk of (adjusted risk ratio [aRR]; 95% CI):
- fatal or nonfatal CVD was higher in those with systolic BP of:
- 140-149 mmHg (1.08; 1.01 to 1.15);
- 150-159 mmHg (1.12; 1.03 to 1.20); and
- ≥160 mmHg (1.19; 1.09 to 1.28).
- incident heart failure was higher in those with systolic BP of ≥160 mmHg (1.28; 1.08 to 1.48).
- stroke was higher in those with systolic BP of:
- 130-139 mmHg (1.17; 1.02 to 1.33);
- 140-149 mmHg (1.23; 1.05 to 1.42);
- 150-159 mmHg (1.24; 1.03 to 1.46); and
- ≥160 mmHg (1.40; 1.19 to 1.61).
- Observational design.
- Risk of unmeasured confounding.