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Battling Blood Pressure: How Low Should You Go?

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Many people with diabetes are unaware of the number one threat to their health: cardiovascular disease. In fact, one survey found that 68% of people with diabetes did not consider cardiovascular disease as a serious potential complication, focusing instead on vision, nerve, and kidney disease. A recent study looks at cardiovascular disease, blood pressure, and diabetes …

Experts recommend that people with diabetes lower blood pressure to below 130/80 mm Hg to reduce the risk of cardiovascular disease. But will lowering blood pressure even more reduce the risk further?

To find out, researchers compared the progression of atherosclerosis (the buildup of plaques in the arteries) in 499 American Indians with diabetes who were treated to either: standard targets (systolic blood pressure less than 130 mm Hg; LDL cholesterol below 100 mg/dL), or 2) more stringent targets (systolic blood pressure below 115 mm Hg; LDL cholesterol less than 70 mg/dL).

After three years, people in both groups, on average, reached their blood pressure and LDL targets. Atherosclerosis in the carotid (neck) arteries regressed in people who received aggressive drug treatment, but it continued to worsen in people treated in the standard way. However, the number of cardiovascular events was similar in both groups.

Longer and larger studies are needed to determine if aggressive treatment of blood pressure and cholesterol pays off with lower rates of cardiovascular disease. In the meantime, if you have diabetes, you should aim for the standard targets -- systolic blood pressure below 130/80 mm Hg and LDL cholesterol below 100 mg/dL.

Reported in the Journal of the American Medical (Volume 299, page 1678).

Posted in Diabetes on April 8, 2010
Reviewed January 2011

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