The cumulative evidence from the recent cardiovascular outcome trials suggests that the effects of GLP-1R activation have a beneficial effect on blood pressure and cardiovascular diseases. However, a robust meta-analysis is needed to compare the controversial results of the different papers in the current literature (Journal of Diabetes Research)
Diabetes News
Category: Hypertension
Blood pressure levels and cardiovascular risk according to age in patients with diabetes mellitus: a nationwide population-based cohort study
In a cohort of hypertensive patients who had DM but no history of cardiovascular disease, lower BP was associated with lower risk of cardiovascular events especially at the age of < 70. However, low BP < 130–139/80–89 mmHg was not associated with decreased cardiovascular risk, it may be better to keep the BP of 130–139/80–89 mmHg at the age of ≥ 70 (Cardiovascular Diabetology)
The Influence of Baseline Diastolic Blood Pressure on the Effects of Intensive Blood Pressure Lowering on Cardiovascular Outcomes and All-Cause Mortality in Type 2 Diabetes
In persons with T2DM, intensive SBP lowering decreased the risk of cardiovascular composite end point irrespective of baseline DBP in the setting of standard glycemic control. Hence, low baseline DBP should not be an impediment to intensive SBP lowering in patients with T2DM treated with guidelines recommending standard glycemic control (Diabetes Care)
Effect of Hemoglobin A1c Reduction or Weight Reduction on Blood Pressure in Glucagon‐Like Peptide‐1 Receptor Agonist and Sodium‐Glucose Cotransporter‐2 Inhibitor Treatment in Type 2 Diabetes Mellitus
Treatment with GLP‐1RA and SGLT2i led to significant reductions in BP in patients with type 2 diabetes mellitus. Weight reduction was significantly and independently associated with BP reductions in GLP‐1RA treatment and SGLT2i treatment (JAHA)
The cross‐sectional association between diabetes and orthostatic hypotension in community‐dwelling older people
Over one‐fifth of older people with diabetes had orthostatic hypotension. Recovery of DBP is related to dynamic changes in total peripheral resistance and impairment of this baroreflex‐mediated response may explain the higher prevalence in diabetes (Diabetic Medicine)
Relation between Blood Pressure Management and Renal Effects of Sodium-Glucose Cotransporter 2 Inhibitors in Diabetic Patients with Chronic Kidney Disease
Our results confirmed that blood pressure management status after treatment with SGLT2 inhibitors influences the extent of change in urinary albumin-creatinine ratio. Stricter blood pressure management is needed to allow the renoprotective effects of sodium-glucose cotransporter 2 inhibitors (Journal of Diabetes Research)
Greater glucagon-like peptide-1 responses to oral glucose are associated with lower central and peripheral blood pressures
Greater glucose-stimulated GLP-1 responses were associated with clinically relevant lower central and peripheral blood pressures, consistent with beneficial effects on the cardiovascular system and reduced risk of CVD and mortality (Cardiovascular Diabetology)
New – Hypertension in adults: diagnosis and management added to T2D guidelines
This guideline covers identifying and treating primary hypertension (high blood pressure) in people aged 18 and over, including people with type 2 diabetes. It aims to reduce the risk of cardiovascular problems such as heart attacks and strokes by helping healthcare professionals to diagnose hypertension accurately and treat it effectively (NICE)
Association between blood pressure variability, cardiovascular disease and mortality in type 2 diabetes
Our results suggest that BPV might provide additional information rather than mean blood pressure on the risk of cardiovascular disease in patients with type 2 diabetes (Diabetes, Obesity and Metabolism)
The association between fasting plasma glucose and glycated hemoglobin in the prediabetes range and future development of hypertension
Our study demonstrates that FPG in the prediabetes range, albeit not glycated hemoglobin, is independently and significantly associated with future development of HTN. Therefore, our findings further highlight the pivotal predictive role of IFG for HTN development as opposed to the limited independent role of abnormal HbA1c levels (Cardiovascular Diabetology)
Effects of intensive blood pressure lowering on mortality and cardiovascular and renal outcomes in type 2 diabetic patients: A meta-analysis
Our data indicate that intensive BP lowering treatment provides greater benefits than less intensive treatment among patients with type 2 diabetes mellitus. Further studies are required to more clearly evaluate the benefits and harms of BP targets below those currently recommended with intensive BP lowering treatment (PLOS ONE)
C-reactive protein and blood pressure variability in type 2 hypertensive diabetic patients
In patients with diabetes and hypertension, higher CRP levels are linked to cardiometabolic derangements, although they are not associated with increased BP variability (Blood Pressure Monitoring)
Managing hypertension in people of African origin with diabetes: Evaluation of adherence to NICE Guidelines
This study provides insight into adherence to NICE guidance for managing hypertension in African origin patients with diabetes. Further work should be done to explore the effects of hypertension in this ethnic group and if there is a need for a more refined management guideline (Primary Care Diabetes)
24-Hour Blood Pressure-Lowering Effect of an SGLT-2 Inhibitor in Patients with Diabetes and Uncontrolled Nocturnal Hypertension: Results from the Randomized, Placebo-Controlled SACRA Study
Non-severely obese older diabetes patients with uncontrolled nocturnal hypertension showed significant BP reductions without marked reductions in glucose with the addition of empagliflozin to existing antihypertensive and antidiabetic therapy. Use of SGLT2 inhibitors in specific groups (e.g. those with nocturnal hypertension, diabetes, and high salt sensitivity) could help reduce the risk of heart failure and cardiovascular mortality (Circulation)
Creatinine Rise During Blood Pressure Therapy and the Risk of Adverse Clinical Outcomes in Patients With Type 2 Diabetes Mellitus
These data suggest that a >30% serum creatinine increase that coincides with lower blood pressure values should not directly lead to a reduction in antihypertensive medication in patients with type 2 diabetes mellitus (Hypertension)
Effect of Achieved Systolic Blood Pressure on Cardiovascular Outcomes in Patients With Type 2 Diabetes: A Population-Based Retrospective Cohort Study
Our findings support a SBP treatment target of 140 mmHg and suspect no risk reduction attenuation on CVD for lower SBP targets (<120 or <130 mmHg) for most patients with uncomplicated T2DM (Diabetes Care)
Reevaluating the Evidence for Blood Pressure Targets in Type 2 Diabetes
The divergent results between ACCORD-BP and SPRINT are most readily explained by the apparent lack of benefit of intensive BP control on CVD and all-cause mortality in ACCORD-BP, rather than differences in the design, population characteristics, or interventions between the trials (Diabetes Care)
Glycemic variability in continuous glucose monitoring is inversely associated with baroreflex sensitivity in type 2 diabetes: a preliminary report
GV was inversely related to BRS independently of blood glucose levels in type 2 diabetic patients. Measurement of BRS may have the potential to predict CV events in consideration of GV (Cardiovascular Diabetology)
Blood pressure targets in type 2 diabetes. Evidence against or in favour of an aggressive approach
Based on the available evidence, it appears that blood pressure targets will probably have to be lower than <140/90 mmHg, and that values approaching 130/80 mmHg should be recommended. However, evidence in favour of even lower systolic values, i.e. <130 mmHg, is limited and is definitively against a reduction to <120 mmHg (Diabetologia)
Intensive Blood Pressure Lowering in Patients With and Patients Without Type 2 Diabetes: A Pooled Analysis From Two Randomized Trials
Intensive blood pressure lowering may have a similar favorable effect and appears to decrease cardiovascular events in both patients with and patients without T2DM (Diabetes Care)
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