The efficacy of antihypertensive treatment on diabetes mellitus or impaired glucose tolerance patients with blood pressure below 140/90 mm Hg: a meta-analysis
10.3760/cma.j.issn.0578-1426.2012.11.011
- VernacularTitle:糖尿病或糖耐量受损人群血压达到140/90mm Hg时继续降压是否有益的Meta分析
- Author:
Xue GENG
;
Wei CUI
;
Xiaohong YANG
;
Ruiqin XIE
;
Jidong ZHANG
;
Hongmei ZHENG
- Publication Type:Journal Article
- Keywords:
Diabetes mellitus;
Blood pressure;
Meta-analysis;
Cardiovascular events
- From:
Chinese Journal of Internal Medicine
2012;51(11):875-879
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate whether antihypertensive treatment is beneficial to patients with diabetes mellitus when their blood pressure (BP) is below 140/90 mm Hg(1 mm Hg =0.133 kPa).Methods MEDLINE,EMBASE,IPA database and secondary resources were searched with terms including blood pressure,hypertension and anti-hypertension drug.Inclusion criteria:random control study; subjects were patients with diabetes mellitus or impaired glucose tolerance; endpoint BP ≤ 140/90 mm Hg; endpoint BP between two groups had significant differences.There were 16 studies meet inclusive criteria with a total of 51 470 patients.RR and 95％ CI were used as index to judge the difference of clinical outcomes between aggressive antihypertensive treatment group and standard antihypertensive treatment group.RevMan5.0 software was used for statistical analysis.Results When BP of patients with diabetes mellitus were below 140/90 mm Hg,anti-hypertensive treatment could reduce incidence rate of cardiovascular event (RR 0.91,95％ CI 0.87-0.96,P =0.0004) and stroke (RR 0.75,95 ％ CI 0.63-0.88,P =0.0005),and increased incidence rate of symptomatic hypotension (RR 3.57,95％ CI 1.41-11.20,P =0.03) and hyperpotassemia (RR 1.57,95％ CI 1.05-2.33,P =0.03).There were no significant differences in all-cause mortality (RR 0.94,95％ CI 0.87-1.01,P =0.08),cardiovascular mortality (RR 0.95,95％ CI 0.85-1.08,P =0.05),myocardial infarction (RR 0.93,95％ CI 0.82-1.05,P =0.26),heart failure (RR 0.90,95％ CI 0.76-1.06,P =0.21) between the aggressive antihypertensive treatment group and standard antihypertensive treatment group.Conclusions When blood pressure of patients with diabetes mellitus was below 140 mm Hg,there was little benefit from aggressive antihypertensive treatment,and the risk of serious adverse events even increased.
