The effect of blood pressure drugs in diabetics and nondiabetes

Dr. Fiona Turnbull and members of the Blood Pressure Lowering Treatment Trialists' Collaboration point out that the effects of blood pressure (BP) lowering medications are broadly comparable in patients with and those without diabetes in preventing major cardiovascular events. Whether specific regimens are more effective in preventing macrovascular disease in diabetes remains unclear. Their findings appear in the Archives of Internal Medicine for June 27th, 2005.

Investigators report that BP level is a major determinant of cardiovascular complications among diabetics. To further investigate this issue, they conducted an overview of prospective randomized trials that compared the effects of different BP lowering regimens in patients with and without diabetes.

Included were 27 trials involving 33,395 individuals with diabetes and 125,314 without diabetes. The studies examined outcomes for angiotensin-converting enzyme (ACE) inhibitors, calcium antagonists, diuretics, beta-blockers, and angiotensin receptor blockers (ARBs). Mean follow-up duration ranged from 2.0 to 8.0 years.

As a conclusion, the authors write: "Clinicians may reasonably choose from a wide range of BP-lowering agents in their efforts to reduce the short- to medium-term risks of macrovascular complications in patients with diabetes.".









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