Lower may not necessarily be better when it comes to target blood pressure readings in individuals with type 2 diabetes, according a study sponsored by the National Heart, Lung and Blood Institute.

The study, conducted by the ACCORD study group, involved over 4,700 participants aged 40 to 79 with type 2 diabetes who either had or were at high risk for cardiovascular disease. The participants were tracked for an average of 4.7 years with the goal of discovering if achieving systolic blood pressure of 120mmHg or less could reduce cardiovascular events.

Researchers reported that those who had received intense treatment to reach an average blood pressure reading of 119.3mmHg required an average of 3.4 medications and those who received standard treatment only needed 2.1 medications on average to reach blood pressure readings of 133.5mmHg. The only endpoints between the two groups reached statistical significance (p<.01 or better) were stroke, with lower rates for the lower blood pressure group (0.32% vs 0.53%), and serious adverse side effects from medication found to be higher in the group with lower blood pressure (3.3% vs 1.3%). Another noteworthy outcome of the study was the finding that overall mortality was actually slightly higher in the group with the lower blood pressure. Not surprisingly, the group with the highest mortality rates were those with uncontrolled hypertension.

Given the data, researchers concluded that intensive blood pressure treatments such as to reach goals of below 120mmHg systolic were not more beneficial than simply reaching the standard goal of less than 140mmHg systolic in high risk type 2 diabetics for reducing fatal and nonfatal cardiovascular events.

Remember, high blood pressure can have very serious consequences and you should never start, stop or change any medication without consulting your doctor.

Source:

Effects of Intensive Blood-Pressure Control in Type 2 Diabetes Mellitus. The ACCORD Study Group. N Engl J Med 2010; 362:1575-1585April 29, 2010. Can be viewed online at http://www.nejm.org/doi/full/10.1056/NEJMoa1001286.