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Lowering blood pressure may not help diabetics

Tight control of blood pressure among patients with diabetes and coronary artery disease does not improve cardiovascular outcomes compared to patients with usual blood pressure control, according to a new study.

July 6, 2010 12:00:00 AM PDT
People with diabetes are more likely to have heart disease, so it's natural for doctors to recommend diabetics keep their blood pressure under control. But now new research indicates that may not be the best strategy.Tight control of high blood pressure gives no better results than moderate control, according to the new study.

Normal blood pressure for healthy people is considered to be 120/80 or lower.

Many people with coronary artery disease have diabetes. So patients like Stephen Elwood are told to keep an eagle eye on their blood pressure. He watches his diet, takes medication and exercises daily.

"I feel fine. I've learned to cope," said Elwood.

In the report provided by the Journal of the American Medical Association, researchers looked at more than 22,000 of these patients who need blood pressure medication. Participants in the tight control group, those who maintained a systolic blood pressure of less than 130, did not do as well as those who maintained readings between 140 and 130.

The research found that patients with diabetes and coronary artery disease did not have fewer strokes or heart attacks when their blood pressure was maintained under 130 compared to patients with usual blood pressure control.

"They did poorly in that more of them died compared to the patients who had blood pressures in the usual control range," said Dr. Carl J. Pepine, MD, chief of cardiovascular medicine at University of Florida's College of Medicine.

But Dr. Pepine says that doesn't mean you can go overboard. Patients whose blood pressure was not controlled or greater than 140 also had poorer outcomes.

Elwood is doing his best to maintain that perfect balance.

"It's amazing what you can do when you deal with what has been given [to] you, you just make it work and I make it work," said Elwood.

So what's the bottom line?

Researchers say for patients with both diabetes and coronary artery disease emphasis should be placed on maintaining a systolic blood pressure between 130 and 139 along with a healthy lifestyle to reduce long-term cardiovascular risk.


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