Intensive vs. Standard Blood Pressure Lowering in Patients with Diabetes

Nearly 15 years ago, results of the ACCORD BP trial were published (NEJM JW Gen Med Apr 15 2010 and N Engl J Med 2010; 362:1575). In that North American trial, 4700 patients with type 2 diabetes, elevated blood pressure (BP), and high cardiovascular (CV) risk were randomized to “intensive” or “standard” systolic BP targets (<120 or <140 mm Hg, respectively). At 5 years, a small difference in incidence of adverse CV outcomes (8.8% vs. 10.0%) did not reach statistical significance, and the optimal BP target remained unsettled.

Now, researchers in China have compared those BP targets in a similar randomized trial that involved ≈13,000 high-risk patients with type 2 diabetes. At 1 year, systolic BP with intensive and standard treatment averaged …