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”

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.