Blood pressure drugs may be harmful for some patients with type 2 diabetes

The researchers found that antihypertensive drugs may increase the risk of cardiovascular death for diabetes patients with a systolic blood pressure under 140 mm/Hg. While almost 1 in 2 people in the US have high blood pressure, or hypertension, the condition affects around 2 in 3 Americans with diabetes, putting them at higher risk of stroke, heart disease and other cardiovascular problems. As such, people with diabetes are often prescribed medication to help lower blood pressure. The American Diabetes Association recommend a systolic blood pressure target of less than 140 mm/Hg for patients with type 2 diabetes - the most common form of diabetes - though a target of less than 130 mm/Hg is recommended for some patients, if it can be achieved safely. The team conducted a meta-analysis of 49 randomized controlled trials - involving a total of 73,738 participants - that looked at the cardiovascular outcomes of people with diabetes who were receiving blood pressure-lowering medication. The vast majority of participants had type 2 diabetes, and subjects were followed-up for at least 12 months. The team looked at the blood pressure of participants before treatment and assessed the cardiovascular effects of antihypertensive medication. The researchers found that participants whose blood pressure was higher than 140 mm/Hg before treatment had a reduced risk of stroke, heart attack, heart failure and all-cause mortality. Among subjects whose blood pressure was less than 140 mm/Hg prior to antihypertensive treatment, however, no cardiovascular benefits were identified. In fact, these participants were found to be at greater risk of cardiovascular death. This 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. The researchers stress that because most study participants had type 2 diabetes, their results may not apply to people with type 1 diabetes or those with diabetes who have normal blood pressure.