Benefits of Early Hypertension Control on Cardiovascular Outcomes in Patients With Diabetes

TLDR: Failure to adequately control BP within 1 year of HT onset significantly increased the likelihood of major cardiovascular events within 3 years, and Prompt control of new-onset HT in patients with diabetes may provide important short-term clinical benefits.

Abstract: RESEARCH DESIGN AND METHODSdStudy subjects were 15,665 adults with diabetes but no diagnosed coronary or cerebrovascular disease at baseline who met standard criteria for new-onset HT. Poisson regression models assessed whether adequate blood pressure control within1 year of HT onset predicts subsequent occurrence of major cardiovascular events with and without adjustment for baseline Framingham Risk Score (FRS) and other covariates. RESULTSdMean age was 51.5 years, and mean blood pressure at HT onset was 136.8/80.8 mmHg. In the year after HT onset, mean blood pressure decreased to 131.4/78.0 mmHg and was ,130/80 mmHg in 32.9% of subjects and ,140/90 mmHg in 80.2%. Over a mean follow-up of 3.2 years, age-adjusted rates of major cardiovascular events in those with mean 1-year blood pressure measurements of ,130/80, 130–139/80–89, and $140/90 mmHg were 5.10, 4.27, and 6.94 events/1,000 person-years, respectively (P = 0.004). In FRS-adjusted models, rates of major cardiovascular events weresignificantlyhigher inthose with mean blood pressure$140/90mmHgin the first year after HT onset (rate ratio 1.30 [95% CI 1.01–1.169]; P =0 .04). CONCLUSIONSdFailure to adequately control BP within 1 year of HT onset significantly increased the likelihood of major cardiovascular events within 3 years. Prompt control of newonset HT in patients with diabetes may provide important short-term clinical benefits. Diabetes Care 36:322–327, 2013