Tight Blood Pressure Control Led to Long-Term Benefits but Not Intensive Glucose Control in Diabetics糖尿病患者严格控制血压而非强化血糖控制有长效

Intensive blood pressure management did while intensive glucose control did not lead to long-term benefits with respect to mortality or macrovascular events in patients with established type 2 diabetes. Surviving participants who had previously been assigned to perindopril–indapamide or placebo and to intensive or standard glucose control participated in a post-trial follow-up evaluation for a median of 5.9 years (blood-pressure–lowering comparison) or 5.4 years (glucose-control comparison). Between-group differences in blood pressure and glycated hemoglobin levels (targeting less than 6.5%) during the trial were no longer evident by the first post-trial visit. The benefits with respect to mortality that had been observed among patients originally assigned to blood-pressure–lowering therapy were attenuated but still evident at the end of follow-up. Intensive glucose control may be important for preventing serious renal complications. Source: http://www.nejm.org/就已确立2型糖尿病患者的死亡率或大血管事件而言，严格地控制血压可导致长期效果，而强化血糖控制则不然。曾被分配到培哚普利和吲达帕胺或安慰剂，并分别接受强化或标准的血糖控制的幸存者参加了平均5.9年（降压比较）和5.4年（血糖控制比较）的试验后随访评估。各组间血压和糖化血红蛋白水平在试验期间（目标是小于6.5％）的差异至试验后第一次随访时已不再明显。最初给予降压治疗的患者中所观察到的死亡率（降低）的益处虽然有所衰减，但在随访结束时仍然明显。强化血糖控制可能对防止严重的肾脏并发症尤其重要。来源：http://www.nejm.org/