Association between difference in blood pressure reduction and risk of cardiovascular events in a type 2 diabetes population: A meta-regression analysis - 14/11/19
, H.H. Le b, T. Bejan-Angoulvant c, d, e, S. Erpeldinger f, R. Boussageon g, B. Kassaï a, b, P. Moulin h, i, F. Gueyffier a, b, M. Cucherat a, b
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Abstract |
Aim |
Recent US recommendations indicate a target blood pressure (BP) of 130/80mmHg for patients with type 2 diabetes (T2D). Our aim was to characterize the association between risk of cardiovascular events and differences in BP decreases in randomized trials of a T2D population.
Methods |
A systematic search was made for randomized clinical trials assessing the effects of antihypertensive treatments in T2D patients on mortality, and fatal and non-fatal cardiovascular events, using a meta-regression technique to explore the influence of BP decreases on treatment effects.
Results |
A total of 88,503 patients from 44 randomized trials were included. There was no significant association between BP decreases and risk of all-cause or cardiovascular mortality, cardiovascular events or myocardial infarction. However, stroke risk was influenced by BP decreases: compared with no reduction, a 10-mmHg reduction in systolic BP was associated with a relative odds ratio (OR) decrease of 33% (OR: 0.67, 95% CI: 0.54–0.82), and a 5-mmHg diastolic BP reduction was associated with a relative OR decrease of 38% (OR: 0.62, 95% CI: 0.50–0.76). Restricting the analysis to double-blind studies did not change the results for diastolic BP.
Conclusion |
A reduction in BP lowers the risk of stroke, but does not appear to affect the risk of other cardiovascular events in a T2D population.
Le texte complet de cet article est disponible en PDF.Keywords : Antihypertensive treatment, Cardiovascular diseases, Diabetes mellitus, Meta-regression, Type 2
Abbreviations : ACC, ACE, AHA, BP, CV, CVD, DBP, FDA, OR, RCT(s), REML, SBP, T2D
Plan
Vol 45 - N° 6
P. 550-556 - décembre 2019 Retour au numéro
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