Why is this important?
- People with T2DM and high BP are at increased risk of CV morbidity and mortality. However, data from randomized controlled trials are insufficient to determine whether optimal BP lowering strategies should be different in people with T2D.
Methodology
- A 1-stage meta-analysis of individual participant-level data (n=358,533) from 51 large randomized controlled trials used the Clinical Trials Specialists Collaboration dataset on treatments lowering blood pressure (Blood Pressure Lowering Treatment Trialists’ Collaboration).
- Funding: British Heart Foundation; UK National Institute for Health Research; Oxford Martin School.
Principle results
- During a median follow-up of 4.2 years, a 5 mmHg reduction in systolic BP significantly reduced the risk of major CV events in people with T2DM (hazard ratio [RR] : 0.94; confidence interval [IC] 95%: 0.91–0.98) and without T2D (RR: 0.89; 95% CI: 0.87–0.92); P interaction = 0,0013.
- Absolute risk reductions did not differ between those with T2DM and those without T2DM.
- No heterogeneity was observed regarding the effects of the treatment according to the initial systolic BP, with or without T2DM.
Limits
- The criteria for T2DM were variable.
- The trials were conducted before the generalization of the use of new hypoglycemic agents, which provide a benefit on the cardiovascular level.
