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Comment & Response
June 2, 2015

Lowering Blood Pressure in Patients With Diabetes

Author Affiliations
  • 1Center for Chronic Disease Outcomes Research, VA Medical Center, Minneapolis, Minnesota
JAMA. 2015;313(21):2182-2183. doi:10.1001/jama.2015.4254

To the Editor In their meta-analysis, Dr Emdin and colleagues1 stated that for persons with diabetes and a baseline systolic blood pressure lower than 140 mm Hg, they observed “lower risks of stroke, retinopathy, and progression of albuminuria,” and therefore recommended further blood pressure lowering for these patients “in contrast with the recommendations of the JNC 8 [eighth Joint National Committee] guidelines.” However, Figure 3 in the article showed no significant reduction in retinopathy with a blood pressure lower than 140 mm Hg, and it is clear from eFigures 4 and 8 that the findings for stroke and albuminuria resulted almost entirely from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial.2

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