For People with Diabetes, Aggressive Blood Pressure Goals May Not Help

Many people with diabetes also have high blood pressure. Clinical guidelines have suggested blood pressure levels in people with diabetes should be kept lower than the standard for people without diabetes. However, a new review from The Cochrane Library does not find support for this practice.

“It’s been clinical practice to try to decrease blood pressure as much as possible in this group in order to reduce both mortality and morbidity,” said Jose Agustin Arguedas, M.D., professor in the department of clinical pharmacology at the University of Costa Rica. Several frequently used clinical guidelines suggest that people with diabetes should have blood pressure less than 130 over 80, he said.

Lowering blood pressure typically means increasing the number or dosage of medications, which can be inconvenient and expensive for patients.

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It's interesting that they were looking at only the macrovascular events - heart attach and stroke.

The microvascular complications of high blood pressure are usually much much more noticed in diabetics but seem to be ignored by that study. e.g. for both retinopathy, kidney disease, high blood pressure is a huge risk factor.