Establishing target systolic and diastolic blood pressure in diabetic patients with hypertension: what do we need to consider?. (2nd November 2021)

• Record Type: Journal Article
• Authors: Thompson, Brian; McEvoy, John W
• Is Part Of: Expert review of cardiovascular therapy. Volume 19:Number 11(2021)
• Page Start: 993
• Page End: 1003
• Publication Date: 2021-11-02
• Subjects: Hypertension -- Type 2 diabetes -- systolic blood pressure -- diastolic blood pressure -- guidelines -- adults -- cardiovascular risk; Cardiovascular agents -- Research -- Periodicals; 616.12061
• DOI: 10.1080/14779072.2021.2013814
• Languages: English
• ISSNs: 1477-9072

Abstract

ABSTRACT: Introduction: The optimum target for systolic and diastolic blood pressure remains divisive. In particular, the conflicting outcomes of the SPRINT and ACCORD trials have led to a divergence of guideline-recommended blood pressure targets for adults with diabetes. Areas covered: Here, we review the existing recommendations for blood pressure targets in diabetes, discussing the evidence base behind them and their limitations. We start by outlining the risks and benefits of lower systolic blood pressure targets among diabetics. We then follow with a separate appraisal of diastolic blood pressure targets, which necessitates examination of the 'J curve' and isolated diastolic hypertension. Expert opinion: Current and emerging evidence supports, on balance, a blood pressure therapeutic target of < 130/90 mmHg in adults at increased risk for cardiovascular disease, including diabetics. Whether certain diabetics with systolic BPs of 120–130 and/or diastolic BPs 80–90 mmHg require drug treatment to a target of <120/80 mmHg is less clear and requires more research.