Low Blood Pressure Isn't Associated with Lower Mortality in Patients with Newly Diagnosed Diabetes

An American Diabetes Association guideline recommends that “most patients with diabetes” receive treatment to reach a systolic blood pressure (SBP) target of <130 mm Hg (although exceptions are allowed for “higher or lower SBP targets” based on patients' characteristics and treatment responses) and a diastolic BP (DBP) target of <80 mm Hg (Diabetes Care 2012; 35 (Suppl 1):S11). Little evidence, however, supports these recommendations. In this retrospective study, investigators used the U.K. General Practice Research Database to examine the effects of SBP and DBP on all-cause mortality in 126,000 adults with newly diagnosed type 2 diabetes.

BP was determined during the first year after diagnosis of diabetes. After median follow-up of 3.5 years, 20% of patients had died. In patients with cardiovascular (CV) disease, those whose SBP was lower than 110 mm Hg were significantly more likely to die than were those whose SBP was 130 to 139 mm Hg (hazard ratio, 2.8); mortality among patients with SBP of 110 to 129 mm Hg was similar to that among patients with SBP of 130 to 139. Participants whose DBP was 70 to 74 mm Hg and those whose DBP was <70 mm Hg were significantly more likely to die than were those whose DBP was 80 to 84 mm Hg (HRs, 1.3 and 1.9, respectively). Similar results were found in patients without CV disease.