Blood Pressure and Diabetes: How Low Should You Go?

Study Suggests Guidelines Calling for Tight Control May Need a Second LookBy Kathleen Doheny

July 6, 2010 -- Tight control of high blood pressure, recommended for those with diabetes by national guidelines, gives no better results than moderate control, according to a new study.

''The guidelines suggest you want diabetics to have [systolic pressure] under 130," says researcher Rhonda M. Cooper-DeHoff, PharmD, associate professor of pharmacy and medicine at the University of Florida, Gainesville.

But in her study, those who kept their systolic pressures moderately controlled -- at 130 to 139 -- did as well as those who controlled it more tightly. Systolic pressure is the upper of the two blood pressure numbers, representing the maximum pressure exerted when the heart contracts.

She compared ranges of blood pressure control on the effect on death, heart attack, and stroke during the follow-up. "There was no difference comparing those with tight control or usual control," she tells WebMD,'' which is contrary to what the guidelines would suggest."

''The message is: we need to get diabetic patients' systolic blood pressure to less than 140, particularly when they have heart disease, but working to get it to less than 130 does not appear to add any additional benefit with regard to the risk of death, stroke, or heart attack," Cooper-DeHoff says.

The study is published in the Journal of the American Medical Association.

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