Influence of pre-treatment blood pressure levels on antihypertensive drug benefits in diabetics: the roadmap experience

Abstract

Purpose: Most guidelines for treatment of hypertension in the setting of diabetes recommend a blood pressure (BP) target of 160/100 from 9 to 2%[[mean BP change −31 (15.7)/ −14 (9.8) mmHg]] and of 140–159/90–99 mmHg from 32 to 11% [[mean BP change −16(12.7)/ −8.9 (8.7) mmHg]], with corresponding increases in the prevalence of patients with baseline BP levels of 120–139/80–99 from 48 to 65% [[mean BP change −4.1 (10.6)/ −3.1 (7.8) mmHg]]and of <120/80 from 11 to 22% [[mean BP change +5.9 (11.8)/+2.5 (8.6) mmHg]]. These effects did not change significantly thereafter and were maintained throughout follow-up. Conclusion: Blood pressure control is feasible in patients with diabetes without nephropathy, independent of baseline BP values. Asymmetric BP-lowering in the first year after starting therapy represents a true antihypertensive effect with sustainable shifts in BP severity.

Keywords

• blood pressure target
• diabetes
• cardiovascular disease
• diabetic nephropathy
• regression to the mean