Blood pressure 2016 update: aggressive hypertension treatment saves lives, but is harmful for diabetics

By: Mohan Garikiparithi | Blood Pressure | Thursday, March 03, 2016 - 01:30 PM

Blood pressure 2016 update: aggressive hypertension treatment saves lives, but is harmful for diabetics

Blood pressure 2016 update: Aggressive hypertension treatment saves lives, but has been shown to be harmful for diabetics. High blood pressure, hypertension, is commonly seen in diabetics, but treating hypertension in diabetes may be difficult, especially as more aggressive hypertension treatments have been shown to pose a greater risk in diabetics.

Main author of the study Mattias Brunström said, “Our study shows that intensive blood pressure lowering treatment using antihypertensive drugs may be harmful for people with diabetes and a systolic blood pressure less than 140 mm Hg. At the same time, it is important to remember that blood pressure lowering treatment is crucial for the majority of people with diabetes whose blood pressure measures above 140.”

The researchers carried out a systematic review and meta-analysis of medical literature in order to uncover the effects of hypertension treatment on diabetics.

The researchers found that the effects of antihypertensive treatment depend on the patient’s blood pressure prior to the treatment. Meaning, if systolic blood pressure prior to treatment was higher than 140 mmHg, then treatment was associated with a decreased risk of death, stroke, heart attack and heart failure. If systolic blood pressure was lower than 140 mmHg, then the risk of death, stroke, heart attack, and heart failure increased in type 2 diabetics.

Mattias Brunström added, “In practice, it is important to remember that undertreatment of high blood pressure is a bigger problem than overtreatment. Many treatment guidelines, both Swedish and international, will be redrawn in the next few years. It has been discussed to recommend even lower blood pressure levels for people with diabetes – maybe as low as 130. We are hoping that our study, which shows potential risks of such aggressive blood pressure lowering treatment, will come to influence these guidelines.”

Aggressive blood pressure control could save lives

Loyola University Chicago took part in a clinical trial, which aims to use more aggressive blood pressure control methods as it could save more lives. The clinical trial consisted of older adults where researchers found that achieving systolic blood pressure of 120 mmHg reduced the rate of cardiovascular events by one-third, and the risk of death was reduced by 25 percent, in comparison to having systolic blood pressure at 140 mmHg.

Eighty-nine patients were enrolled in the clinical trial known as Systolic Blood Pressure Intervention Trial (SPRINT).

Principal investigator Holly Kramer said, “This is the first clinical trial to confirm that a more intensive blood pressure regimen improves cardiovascular outcomes.”

Primary sponsor Gary H. Gibbons added, “The study provides potentially lifesaving information that will be useful to health care providers as they consider the best treatment options for some of their patients, particularly those over age 50. We are delighted to have achieved this important milestone in the study in advance of the expected closure date for the SPRINT trial and look forward to quickly communicating the results to help inform patient care and the future development of evidence-based clinical guidelines.”

The study evaluates the maintenance of a new target systolic number – 120 mmHg – and found that new aggressive methods to achieve systolic blood pressure at 120 mmHg can be effective for reducing the risk of cardiovascular events along with preventing early death. Hypertension is a known risk factor for many cardiovascular events, and although lifestyle habits can help bring numbers down to healthy levels, sometimes medication is prescribed to further reduce numbers.

Although the findings reveal the benefits of systolic blood pressure at 120 mmHg, there is still an ongoing debate in the medical community of safe treatment methods for healthy blood pressure. For now, it is best to stick with your own doctor’s advice based on your own needs in order to maintain healthy blood pressure.


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Risk of ‘bleeding’ stroke higher with untreated blood pressure

Sources:

http://www.umu.se/english/about-umu/news-events/news/newsdetailpage/intensive-blood-pressure-lowering-treatment-may-harm-people-with-diabetes.cid263751
http://www.bmj.com/content/352/bmj.i717
http://www.newswise.com/articles/more-aggressive-blood-pressure-treatment-found-to-reduce-heart-disease-and-save-lives

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