A Chinese parallel design, randomized clinical trial showed that the incidence of major cardiovascular events among patients with type 2 diabetes (T2D) was significantly lower with intensive treatment targeting a systolic blood pressure (SBP) of less than 120 mm Hg than with standard treatment targeting a SBP of less than 140 mm Hg. A total of 12,821 T2D patients 50 years of age or older (mean age 63.8 years, 45.3% women; 6414 patients in the intensive-treatment group and 6407 in the standard-treatment group) were enrolled from February 2019 through December 2021. At 1 year of follow-up, the mean SBP was 121.6 (median, 118.3) mm Hg in the intensive-treatment group and 133.2 (median, 135.0) mm Hg in the standard-treatment group. During a median follow-up of 4.2 years, primary-outcome events (a composite of nonfatal stroke, nonfatal myocardial infarction, treatment or hospitalization for heart failure, or death from cardiovascular causes) occurred in 393 patients (1.65 events per 100 person-years) in the intensive-treatment group and 492 patients (2.09 events per 100 person-years) in the standard-treatment group (hazard ratio, 0.79). Fatal or nonfatal stroke, the most common type of cardiovascular disease among Chinese, occurred in 284 patients (1.19 events per 100 person-years) in the intensive-treatment group and in 356 patients (1.50 events per 100 person-years) in the standard-treatment group (hazard ratio, 0.79). The benefits of intensive BP control were consistent across all prespecified subgroups. The incidence of serious adverse events was similar in the groups. However, symptomatic hypotension and hyperkalemia occurred more frequently in the intensive-treatment group than in the standard-treatment group. The finding is consistent with some other trials and provides convincing evidence of the benefits of lowering SBP to a target of less than 120 mm Hg in T2D patients. The benefits of lowering SBP to a target of less than 120 mm Hg is known in patients without diabetes. Source: https://www.nejm.org/
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