Intensive Blood-Pressure Lowering in Patients with Type 2 Diabetes
Primary result · Composite of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina or heart failureResult — go to the resultHazard ratio 0.90 95% CI 0.77–1.06Authors' conclusion
Among patients with type 2 diabetes, targeting a systolic blood pressure of less than 120 mm Hg, as compared with less than 140 mm Hg, did not reduce the occurrence of major cardiovascular events. (Funded by Hospital Israelita Albert Einstein and the Brazilian Ministry of Health; OPTIMAL-DIABETES ClinicalTrials.gov number, NCT04040634.).
Study context
- Population
- Patients with elevated blood pressure, type 2 diabetes, and high cardiovascular risk; ethnically diverse; mean (±SD) age 64.7±8.2 years, 62.0% womenenrolled
- Participants
- 9,476 patients
- Comparison
- Intensive therapy targeting a systolic blood pressure of less than 120 mm Hg vs standard therapy targeting less than 140 mm Hg
- Intensive therapyn = 4,745
- Standard therapyn = 4,731reference
- Primary endpoint
- Composite of:
- Death from cardiovascular causes
- Nonfatal myocardial infarction
- Nonfatal stroke
- Hospitalization for unstable angina or heart failure
- Follow-up
- Median 4.0 years (interquartile range, 3.9 to 4.0)
Methodological detailsconducted in Brazil
- Conducted in Brazil
Primary result
As reported in the abstract
Hazard ratio
0.90
95% CI 0.77–1.06
P = 0.20
Events by treatment group
Intensive therapy
6.0%; 1.65 events per 100 person-years
286 of 4745
Standard therapy
6.7%; 1.83 events per 100 person-years
315 of 4731
Further findings
Mean systolic blood pressure during follow-up (with exclusion of the first 3 months)
Safety
Serious adverse events
Original publication
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