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Treating hypertension aggressively in people with diabetes becomes even more important. The higher the systolic blood pressure the greater the rate of progression in the carotid intimamedia thickness (CIMT) A group of investigators led by Dr Wendy Mack of the University of Southern California, Los Angeles, USA, assessed whether the use of antihypertensive medication affects carotid intima-media thickness (CIMT) in patients with type 2 diabetes.
A total of 276 patients (90 men, 186 women) who had participated in the Troglitazone Atherosclerosis Regression Trial (TART) and had been evaluated for CIMT at baseline with 1 or more follow-up measurements were included. Change in CIMT, hypertension treatment, and blood pressure were recorded over a 2-year period. High-resolution B-mode carotid artery ultrasound was used to measure CIMT. The primary endpoint of this post hoc cohort analysis was the annual rate of change in CIMT.
The investigators found that 184 patients (67%) used antihypertensive medication during the trial. The median duration of use was 1.8 years (range 0.02-2.2 years). Overall, higher systolic blood pressure was associated with a higher rate of progression in CIMT (p=0.03).
Antihypertensive treatment lessened this association in a duration-dependent manner (p for interaction=0.035), even after adjustment for age, treatment, and change in fasting glucose during the trial.
The investigators concluded that regular use of antihypertensive medication slowed the progression of atherosclerosis in patients with type 2 diabetes.
American Journal of Cardiology 2007;99:956-60
Glucose, and Impaired Glucose Tolerance. The Australian Diabetes, Obesity, and Lifestyle Study (AusDiab), E.L.M. Barr MPH, P.Z. Zimmet PhD, T.A. Welborn PhD, D. Jolley MSc, D.J. Magliano PhD, D.W. Dunstan PhD, A.J. Cameron MPH, T. Dwyer MD, H.R. Taylor MD, A.M. Tonkin MD, T.Y. Wong PhD, J. McNeil PhD, and J.E. Shaw MD
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