Safely reduce BP in patients with diabetes and heart disease

New study revealed that there is an increased risk of heart attack and stroke for patients having blood pressure either too high or too low. Systolic blood pressure above 120 in patients with diabetes and coronary artery disease is safer. Levels between 130 and 140 appear to be the most healthful.

The new study was presented by Rhonda Cooper-DeHoff, Pharm.D., an associate professor of pharmacy and medicine at UF, at the 59th annual scientific session of American College of Cardiology, in Atlanta.

Based on hypertension treatment guidelines, health-care practitioners have assumed that with regard to blood pressure, “the lower, the better,” Cooper-DeHoff said. But, The International Verapamil SR-Trandolapril study, known as INVEST, suggests that the range considered normal for healthy Americans may actually be risky for those with a combined diagnosis of diabetes and coronary artery disease.

“Our data suggest that in patients with both diabetes and coronary artery disease, there is a blood pressure threshold below which cardiovascular risk increases,” Cooper-DeHoff said.

As many as two out of three adults with diabetes have high blood pressure. Normal blood pressure as defined by the American Heart Association is less than 120 systolic and less than 80 diastolic. Blood pressure greater than 140 is still associated with a nearly 50 percent increase in cardiovascular risk in patients with diabetes. But efforts to reduce systolic blood pressure to below 130 did not appear to offer any additional benefit to diabetics with coronary artery disease compared with reduction of systolic blood pressure to between 130 and less than 140.

Cooper-DeHoff’s study reveals for the first time that this group of patients also had a similar increase in risk when their blood pressure was controlled to lower than 115 systolic – the range recommended as normal by the American Heart Association.

This as an important study for doctors treating patients with diabetes and cardiovascular disease.

Source: University of Florida, USA

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