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Prof. Redon tells us about a J-shaped relationship between lowering blood pressure and mortality uncovered by the ONTARGET study in patients with diabetes.
Milan, Italy –Aggressive lowering of blood pressure could put diabetics at increased risk of mortality, according to Josep Redon, MD, Professor of Medicine at the University of Valencia in Spain.
The ONTARGET trial with more than 26,000 subjects, of whom 9,600 were diabetic, has found that bringing blood pressure below around 130 mmHg systolic, diastolic 80 mmHg, put diabetic patients at increased risk of myocardial infarction if they had additional cardiovascular risk factors. But ONTARGET trial patients who were more at risk of stroke than coronary artery disease still benefited from systolic reduction to 115.
The message is that if you have a patient with diabetes, then if your patient has more risk of a stroke you can go down to lower pressures with benefits. But if your patient has more risk of coronary disease you have to be very careful of this, and you should keep the blood pressure not too low,” Professor Redon said in an interview after his presentation at the Milan conference.
He noted that the balance of this J-shaped relationship of risks in your patient needs to be assessed – between coronary artery and stroke risks – in order to decide on the target for blood pressure reduction.