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Blood pressure control and the association with diabetes mellitus incidence: Results from SPRINT randomized trial

Hypertension Jan 07, 2020

Roumie CL, Hung AM, Russell GB, et al. - Researchers examined diabetes mellitus [fasting blood glucose ≥ 126 mg/dL (6.99 mmol/L), diabetes mellitus self-report, or new use of hypoglycemics] incidence in the SPRINT (Systolic Blood Pressure Intervention Trial). SPRINT is a randomized trial in which intensive blood pressure strategy (systolic blood pressure < 120 mm Hg) was compared with standard strategy (< 140 mm Hg). Participants were aged ≥ 50 years, with systolic 130 to 180 mm Hg and heightened cardiovascular risk. Assignment of 4,187 and 4,193 participants was done to intensive and standard strategies, respectively. Two hundred ninety-nine incident diabetes mellitus events were reported (2.3% per year) for intensive and 251 events (1.9% per year) for standard, rates of 22.6 (20.2–25.3) vs 19.0 (16.8–21.5) events per 1,000 person-years of treatment, respectively. For intensive and standard strategies, they noted impaired fasting glucose rates of 26.4 (24.9–28.0) and 22.5 (21.1–24.1) per 100 person-years. Observations suggest no association of intensive treatment strategy with increased diabetes mellitus but it was linked with more impaired fasting glucose. They suggest considering the risks and benefits of intensive blood pressure targets in individualized patient treatment goals.
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