Blood pressure drugs may raise heart attack risk for diabetes patients

While patients with systolic pressure above 140 saw health benefits, those with pressure at or below 140 saw potential risks go up.

By Stephen Feller

UMEA, Sweden, Feb. 25 (UPI) -- Although many with diabetes have high blood pressure, and it is important for these patients to keep blood pressure under control, a new study suggests aggressive treatment may increase risk for heart attack.

Researchers in Sweden found in a large study that diabetic patients with systolic blood pressure lower than 140 before treatment with antihypertensive drugs had a higher chance for heart attack.


More than 70 million people in the United States have high blood pressure, considered a systolic pressure above 140 and diastolic pressure above 90. Recommendations for controlling blood pressure have long aimed for 140, however recent research found more aggressive treatment -- setting a goal for systolic pressure of 120 -- can significantly lower the risk of cardiovascular events and death.

Health benefits have been seen when aiming for an even lower blood pressure, but diabetic patients face other health concerns that complicate such strong treatment goals.

"In practice, it is important to remember that undertreatment of high blood pressure is a bigger problem than overtreatment," Mattias Brunström, a doctoral student at Umeå University, said in a press release. "Many treatment guidelines, both Swedish and international, will be redrawn in the next few years. It has been discussed to recommend even lower blood pressure levels for people with diabetes -- maybe as low as 130. We are hoping that our study, which shows potential risks of such aggressive blood pressure lowering treatment, will come to influence these guidelines."


For the study, published in the British Medical Journal, researchers reviewed 49 trials including 73,738 participants, most of whom had type 2 diabetes, to find the effects of varying levels of blood pressure treatment.

For patients with systolic pressure above 150, aggressive blood pressure treatment lowered the risk of any type of death, death from a cardiovascular event, heart attack, and kidney discharge. With a baseline systolic pressure between 140 and 150, treatment also was seen to reduce death, heart attack, and heart failure.

Patients with systolic pressure lower than 140, however, saw an increased risk of heart attack, a cardiovascular event leading to death, or any cause of death.

"Our study shows that intensive blood pressure lowering treatment using antihypertensive drugs may be harmful for people with diabetes and a systolic blood pressure less than 140 mm Hg," Brunström said. "At the same time, it is important to remember that blood pressure lowering treatment is crucial for the majority of people with diabetes whose blood pressure measures above 140."

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