Cardiovascular outcomes under hypothetical blood‐pressure‐lowering intervention in type 2 diabetes: A target trial emulation
Authors' conclusion
Among Chinese patients with type 2 diabetes, maintaining SBP ≤120 mmHg may not be an optimal target, in terms of the risk-benefit association of CVD and all-cause mortality.
Study context
- Population
- Patients with T2D from the Kailaun study (Chinese)
- Participants
- 4,264 patients
- Comparison
- Hypothetical interventions maintaining systolic blood pressure (SBP) below 140, 130 and 120 mmHg vs no intervention
- Outcome
- Risk of cardiovascular disease (CVD) and all-cause mortality (RR and NNT)
- Follow-up
- 10-year
Methodological detailsparametric g-formula, accounting for time-varying confounding
- Parametric g-formula
- Accounting for time-varying confounding
Main finding
As reported in the abstract
CVD
Each group vs no interventionRelative risk (95% CI)
SBP <140 mmHg18% relative risk reduction; NNT 32
0.82(0.75–0.88)
SBP <130 mmHg24% relative risk reduction; NNT 24
0.76(0.69–0.86)
SBP ≤120 mmHg31% relative risk reduction; NNT 19
0.69(0.58–0.84)
Further findings
| Outcome | RR (95% CI) | |
|---|---|---|
| All-cause mortality · 10-yearSBP <140 mmHgvs No intervention | 0.98 (0.93–1.06) | |
| All-cause mortality · 10-yearSBP <130 mmHgvs No intervention | 1.04 (0.95–1.12) | |
| All-cause mortality with SBP ≤120 mmHg · 10-yearSBP ≤120 mmHgvs No interventionSignificantly increased 15% | 1.15 (1.02–1.32) | |
| 0.512Relative risk (log scale) |
Subgroups: age ≥60 years or without antihypertensive agents
- Maintaining SBP ≤120 mmHg tended to bring more harms than benefits in patients aged ≥60 years or without antihypertensive agents
Original publication
Cardiovascular outcomes under hypothetical blood‐pressure‐lowering intervention in type 2 diabetes: A target trial emulation. Diabetes Obes Metab. Published 20 January 2026. doi:10.
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