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Is Lower BP Better in Type 2 Diabetes?

Jan 26, 2019

According to a recent study, which of the following is true among patients with type 2 diabetes (T2DM) and recent acute coronary syndrome (ACS)?



Correct Answer: E. A&B

Explanation: In EXAMINE, a cardiovascular (CV) outcomes trial of >5,300 patients with T2DM and recent ACS, SBPs <130 mm Hg and DBPs less than or equal to 71 mm Hg were associated with a significantly greater risk for MACE compared with SBPs of 131-140 mm Hg and DBPs of 81-90 mm Hg. (MACE was defined as a composite of death resulting from CV causes, nonfatal myocardial infarction, and nonfatal stroke.) Adjusted hazard ratios for other endpoints, including the composite of CV death or heart failure, were significantly higher in patients with SBPs <130 mm Hg and DBPs <80 mm Hg. These results suggest that intensively managing BP in patients with T2DM and ischemic heart disease may cause harm. More research is needed to further investigate these findings. https://www.ahajournals.org/doi/full/10.1161/JAHA.118.009114