An intensive SBP lowering target of 110 to <130 mmHg reduces the cardiovascular outcomes compared with a standard SBP lowering target of 130 to <150 mmHg. The findings of this study support the favorable effects of intensive SBP lowering in hypertensive patients with diabetes (Diabetes, Obesity and Metabolism)
Diabetes News
Category: Hypertension
Mechanisms underlying the blood pressure lowering effects of empagliflozin, losartan and their combination in people with type 2 diabetes: a secondary analysis of a randomized cross-over trial
In people with T2D, SGLT2 inhibition in combination with ARB had a larger blood-pressure lowering effect versus placebo than either of the drugs alone. Our data further suggest that the mechanisms underlying these blood pressure reductions at least partially differ between these agents (Diabetes, Obesity and Metabolism)
Blood pressure-lowering treatment for prevention of major cardiovascular diseases in people with and without type 2 diabetes: an individual participant-level data meta-analysis
Our analyses challenge the adoption of differential blood pressure thresholds, intensities or drug classes in people with and without type 2 diabetes. This study calls for the removal of specific blood pressure thresholds when selecting people with type 2 diabetes for antihypertensive therapy (The Lancet Diabetes & Endocrinology)
Mechanisms underlying the blood pressure lowering effects of dapagliflozin, exenatide, and their combination in people with type 2 diabetes: a secondary analysis of a randomized trial
The dapagliflozin-induced plasma volume contraction may contribute to the initial SBP reduction, while a reduction in SNS activity may contribute to the persistent SBP reduction (Cardiovascular Diabetology)
Using genetics to assess the association of commonly used antihypertensive drugs with diabetes, glycaemic traits and lipids: a trans-ancestry Mendelian randomisation study
Our findings suggest protective association of genetically proxied ACE inhibition with diabetes, while genetic proxies for BBs and CCBs possibly relate to an unfavourable metabolic profile (Diabetologia)
Lowering of blood pressure and pulse rate by switching from DPP-4 inhibitor to luseogliflozin in patients with type 2 diabetes complicated with hypertension: a multicenter, prospective, randomized, open-label, parallel-group comparison trial (LUNA study)
Switching from DPP-4i to luseogliflozin decreased nighttime SBP and PR; moreover, BP circadian rhythm was improved (Diabetes Research and Clinical Practice)
Intensive versus standard blood pressure control in type 2 diabetes: a restricted mean survival time analysis of a randomised controlled trial
Intensive BP treatment may reduce death and cardiovascular events among patients with type 2 diabetes receiving standard glycaemic treatment and without cognitive impairment (BMJOpen)
The Effects of Glucagon-Like Peptide-1 Receptor Agonists and Dipeptydilpeptidase-4 Inhibitors on Blood Pressure and Cardiovascular Complications in Diabetes
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)
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)
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