Target Blood Pressure in Diabetes.

Kim,  Dong Jun

doi:2013.14.1.1

J Korean Diabetes > Volume 14(1); 2013 > Article

Opinion

The Journal of Korean Diabetes 2013;14(1):1-5.
DOI: https://doi.org/10.4093/jkd.2013.14.1.1 Published online March 31, 2013.

당뇨병환자에서 혈압 조절의 목표

김동준

Target Blood Pressure in Diabetes.

Dong Jun Kim

Department of Internal Medicine, Inje University College of Medicine, Goyang, Korea. djkim@paik.ac.kr

Abstract

Many epidemiologic analyses and several clinical trials have shown that lowering blood pressure improved clinical outcomes. The benefits of lowering blood pressure were more prominent in cases of diabetes than in non-diabetic patients. Several randomized trials have demonstrated the benefit of lowering diastolic blood pressure to < 80 mm Hg in people with diabetes. However, the evidence for benefits associated with systolic blood pressure of < 130 mm Hg is limited. Recently, the Action to Control Cardiovascular Risk in Diabetes study reported that, in people with type 2 diabetes, targeting a systolic blood pressure (SBP) of less than 120 mm Hg, as compared with less than 140 mm Hg, did not reduce the rate of a composite outcome of fatal and nonfatal cardiovascular events. In actuality, a higher incidence of serious adverse events occurred in the group of SBP < 120 mm Hg. With lack of evidence demonstrating any benefit from lowering SBP to < 130 mm Hg, SBP < 130 mm Hg as a general target in the treatment of diabetes seems to be inappropriate. However, considering that several studies have reported a linear relationship between blood pressure and stroke, compared to the J-shaped relationship between blood pressure and cardiovascular disease, blood pressure goals need to be developed based upon the individualized characteristics of each patient.

Key Words: Diabetes mellitus, Hypertension, Blood pressure