Continued BP control important in T2DM (UKPDS)

General

Clinical Question:
Is the benefit of blood pressure control in type 2 diabetes mellitus sustained after 10 years?

Bottom Line:
Good control of blood pressure (defined as < 150/85 in this study) in patients with diabetes is critical, and this study reinforces the importance of maintaining good blood pressure control over time. (LOE = 2b)

Reference:
Holman RR, Paul SK, Bethel MA, Neil HA, Matthews DR. Long-term follow-up after tight control of blood pressure in type 2 diabetes. N Engl J Med 2008;359(15):1565-1576.  [PMID:18784091]

Study Design:
Cohort (prospective)

Setting:
Outpatient (any)

Synopsis:
This is a follow-up to the landmark United Kingdom Prospective Diabetes Study trial. Initially, 1148 patients with newly diagnosed type 2 diabetes mellitus and hypertension were randomized in a 2-to-1 ratio to tight blood pressure control with captopril or atenolol (target blood pressure of < 150/85 mm Hg) or less tight control without either drug (< 180/105 mm Hg). The mean age of patients was 56 years and 87% were white. The study found important reductions in any diabetes-related end point (including death), stroke, and microvascular disease among patients randomized to the tight control group over the 8-year mean follow-up period. At the end of the study, patients who had not died, emigrated, or dropped out (n = 884) were followed up for another 10 years. At the end of the 10-year period, 372 patients had completed post-trial monitoring. Over the 10-year period, differences in systolic and diastolic blood pressure between tight and loose blood control groups largely disappeared, as did benefits of tight control.

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Citation

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TY - ELEC T1 - Continued BP control important in T2DM (UKPDS) ID - 426348 ED - Barry,Henry, ED - Ebell,Mark H, ED - Shaughnessy,Allen F, ED - Slawson,David C, BT - EE+ POEM Archive UR - https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426348/all/Continued_BP_control_important_in_T2DM__UKPDS_ PB - John Wiley & Sons DB - Evidence Central DP - Unbound Medicine ER -