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Invited Commentary
Sep 24, 2012

Use of a Single Target Blood Pressure Level in Type 2 Diabetes Mellitus for All Cardiovascular Risk Reduction: Comment on “Intensive and Standard Blood Pressure Targets in Patients With Type 2 Diabetes Mellitus”

Author Affiliations

Author Affiliations: Section of Nephrology and Hypertension, First Department of Medicine, American Hellenic Educational Progressive Association Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece (Dr Sarafidis); and Department of Medicine, ASH (American Society of Hypertension) Comprehensive Hypertension Center, Department of Medicine, The University of Chicago, Chicago, Illinois (Dr Bakris).

Arch Intern Med. 2012;172(17):1304-1305. doi:10.1001/archinternmed.2012.4020

For more than 15 years, all major clinical practice guidelines have recommended a target blood pressure (BP) of less than 130/80 mm Hg for patients with diabetes mellitus (DM).1 This BP value is based almost exclusively on the results of retrospective analyses of primary outcomes trials.

The first prospective trial to randomize patients with type 2 DM (T2DM) to target BPs and examine their cardiovascular (CV) outcomes was the UKPDS 38 by the United Kingdom Prospective Diabetes Study Group.2 In that trial, the group randomized to tighter BP control had a mean BP of 144/82 mm Hg and demonstrated significant reductions in DM-related deaths and complications compared with the group randomized to usual control, whose mean systolic BP was 10 mm Hg higher.

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