Article Text

Download PDFPDF
In search for the ‘sweet spot’ for blood pressure level in diabetes
  1. Hala Yamout,
  2. George L Bakris
  1. Department of Medicine, The ASH Comprehensive Hypertension Center, The University of Chicago Medicine, Chicago, Illinois, USA
  1. Correspondence to Dr George Bakris, ASH Comprehensive Hypertension Center, 5841 S. Maryland Ave., MC 1027 Chicago, IL 60637, USA; gbakris{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

There have been numerous analyses of clinical trials in people with diabetes assessing the effect of blood pressure level on cardiovascular outcomes including hospitalisations. Only two trials, however, have prospectively randomised blood pressure levels in patients with type 2 diabetes to evaluate cardiovascular outcome, The United Kingdom Prospective Diabetes Study (UKPDS)1 and the Action to Control Cardiovascular Risk in Diabetes (ACCORD).2 Unfortunately, only the ACCORD was designed to determine the effect of cardiovascular outcomes to a goal blood pressure of <120/80 mm Hg. While the UKPDS showed a lowered cardiovascular event rate, they attained a lower BP goal of 144/82 mm Hg, the ACCORD failed to show an advantage of lower blood pressure on outcomes.

Post hoc analyses of trials that had large subgroups of patients with type 2 diabetes such as the International Verapamil SR—Trandolapril (INVEST)3 and the Avoiding Cardiovascular Events in Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH)4 also failed to demonstrate a cardiovascular outcome benefit at a blood pressure below 130/80 mm Hg. One …

View Full Text


  • Contributors No one besides the authors contributed to this editorial.

  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

Linked Articles