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Table 1 Studies addressing the definition of the goal of blood pressure control in patients with diabetes and hypertension

From: The goal of blood pressure in the hypertensive patient with diabetes is defined: now the challenge is go from recommendations to practice

Study Ref Number of subjects Design BP (mmHg) target by groups BP (mmHg) achieved Main results
INVEST 58 6,400 Observational subgroup analysis Group 1. SBP<140 Group 1. 159/86 Group 1 have 50% higher risk of death, MI, or stroke (P< 0.0001). Group 3 in relation to group 2 have an increase of 8% of CVD after 5 years of study (p<0.04).
     Group 2. SBP<140-130 Group 2. 149/85  
       Higher incidence of death in patients with SBP<115.
     Group 3. SBP<130 Group 3. 144/85  
ACCORD-BP 43 4,733 Randomized clinical trial (RCT) Group 1. Intensive SBP<120 Group 1. 119.3/64.4 No differences in the primary end point (MI, stroke and CV death) or in death due to any cause. Higher incidence of stroke (p= 0.01) or non-fatal stroke (p=0.03). Increase of adverse events in group 1.
     Group 2. Standard SBP < 140 Group 2. 133.5/70.5  
IDN-T 59 1,590 Post hoc analysis ≤135/85 30% reach the SBP goal and 81% the DBP goal Progressively lower achieved SBP to 120 predicted a decrease in CV mortality and CHF but not MI. A SBP <120 was associated with increased CV deaths and CHF events. DBP< 85 was associated with increase of all-cause mortality, MI mortality but decrease risk of stroke.
ABCD-NT 60,61 470 RCT Group 1. DBP<75-79 132/78 No differences in any CV events, or progression of renal disease, nor retinopathy.
     Group 2. DBP 80-89 138/86  
ONTARGET 62 9,603 Post hoc analysis Group 1. SBP 95-130 125.8 SD 12.0 Increased CV mortality with SBP < 125 in relation with SBP < 130.
     Group 2. SBP 131-142 132.4 SD 11.2  
     Group 3. SBP 143-154 137.7 SD 11.5  
     Group 4. SBP 155-200 144.3 SD 12.6  
ROADMAP 63 4,447 RCT Group 1. SBP<130 80% achieved the target SBP<120 showed a J-shaped increase of CV mortality.
     Group 2. DBP<80   
UKGPRD 64 126,092 Retrospective study Group 1. <130/<80 Achieved target J-shaped relationship in patients with SBP<130 In patients with CVD SBP <130 and DBP< 80 was not associated with improved survival. BP <110/75 increase the risk of CV mortality.
   12,379 with CVD   Group 2. 130-139/80-<85 Group 1. SBP18.1%  
     Group 3. ≥140/≥85 DBP 35.7%  
      Group 2. SBP 19.9%  
      DBP 27.7%  
      Group 3. SBP 61%  
      DBP 36.6%  
HOT 65 1,501 RCT Group 1. DBP<90 Group 1. 144/85 DBP<80 showed a significantly reduction in CV events and CV mortality.
     Group 2. DBP<85 Group2. 141/83  
     Group 3. DBP<80 Group 3. 140/81  
UKPDS 71 4,801 Post hoc observational analysis Group 1. <150/85 Group 1. 144/82 Group 1 had a significant 44% reduction of stroke, 32% of diabetes related death, 24% diabetes related end patients.
     Group 2. <180/105 Group 2. 154/87  
  1. BP= blood pressure, SBP=systolic BP, DBP= diastolic BP, MI=myocardial infarction, CVD= cardiovascular diseases CV=cardiovascular, CHF= congestive heart failure.