Intensive blood pressure therapy did not cut cardiovascular events in adults with diabetes
Intensive blood pressure-lowering treatment to reduce systolic pressure below 120 mm Hg in adults with type 2 diabetes, who are at increased risk of cardiovascular events, did not significantly reduce the incidence of cardiovascular death, stroke, heart attack or other cardiovascular events, compared to standard treatment targeting a systolic blood pressure of less than 140 mm Hg.
New research presented at the American Heart Association's Scientific Sessions 2026 in Chicago suggests that intensive blood pressure treatment aimed at reducing systolic pressure below 120 mm Hg in adults with type 2 diabetes did not significantly lower the occurrence of major cardiovascular events such as death, stroke, heart attack, or hospitalization for heart failure compared to standard treatment targeting a systolic blood pressure of less than 140 mm Hg.
The OPTIMAL-DIABETES trial, which included over 9,000 participants aged 50 and older with elevated blood pressure (130-180 mm Hg), type 2 diabetes, and cardiovascular disease, chronic kidney disease, or other risk factors, showed a 10% lower risk of major cardiovascular events in the intensive-treatment group, but this difference was not statistically significant.
The intensive treatment group had a 55% higher risk of kidney-related events compared to the standard-treatment group, though end-stage renal disease was similar between groups. The study's lead author, Dr. Karla Santo, believes the findings highlight the need for individualized blood pressure management, adjusting targets based on patient-specific factors, and emphasizes the importance of balancing potential cardiovascular benefits with kidney effects, treatment burden, and patient preferences.
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