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Blood pressure management in type 2 diabetes: a review of recent evidence
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  • Published on: 13 August 2024
    mitigating the risk of hypertension-related atrial fibrillation

    No review of intensity of blood pressure lowering treatment in Type 2 diabetes can ever be complete without taking into account four parameters, namely:-
    (i)Hypertension as a risk factor for atrial fibrillation(AF)
    (ii)The relationship between intensity of blood pressure lowering and mitigation of the risk of incident atrial fibrillation.
    (iii)The association between diabetes and atrial fibrillation, including the possibility that this might be a causal relationship.
    (iv) The association between obesity and atrial fibrillation, including the causal relationship between obesity and Type 2 diabetes.
    Each of those parameters has a potential therapeutic dimension as follows:-
    Hypertension is the most prevalent risk factor for atrial fibrillation[1], and it is now recognised that intensive lowering of blood pressure, down to a systolic blood pressure of < 120 mm Hg, generates a significant reduction in the risk of incident atrial fibrillation[2]. In the latter study 4003 subjects were randomly allocated to the strategy of achieving a goal systolic blood pressure of < 120 mm Hg, and 4019 were randomly allocated to achieve s goal systolic blood pressure of < 140 mm Hg. During a 5.2 year follow up intensive treatment was associated with 26% lower risk of incident AF(Hazard Ratio, 0.74;95% Confidence Interval 0.56-0.98)[2].
    Given the association between diabetes and AF which was shown in the systematic review by Alija et al[3]...

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    Conflict of Interest:
    None declared.