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(Circulation. 2003;107:e9008.)
© 2003 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Keeping the Pressure Down in Patients With Type 2 Diabetes and Peripheral Artery Disease

Intensive blood-pressure lowering reduced the risk of ischemic events in the small population of patients with diabetes and peripheral artery disease, according to a report from Colorado researchers in this week’s issue of Circulation (Circulation. 2003;107:753–756).

Scientists led by Philip S. Mehler, MD, of the University of Colorado Health Sciences Center in Denver, monitored 950 subjects in the Appropriate Blood Pressure Control in Diabetes (ABCD) study for 5 years. All patients had type 2 diabetes and 480 were considered to have normal blood pressures with baseline diastolic pressure of 80 to 89 mm Hg. Those who received placebo had a mean blood pressure of 137±0.7/81±0.3 mm Hg over the last 4 years of the study. By contrast, patients randomized to intensive treatment maintained a 4-year blood pressure of 128±0.8 / 75±0.3 mm Hg. Peripheral artery disease was identified in 53 patients.

In patients with peripheral artery disease who received intensive treatment, 13.6% (3 patients) suffered a cardiovascular event compared with 38.7% (12 patients) on placebo—even though members of both groups had what is considered normal blood pressure.

The authors concluded that peripheral artery disease "is a common presentation of atherosclerosis and is also a strong independent predictor of future cardiovascular ischemic events. Our results suggest that blood pressure lowering in normotensive type 2 diabetic patients with PAD [peripheral artery disease] is particularly effective in preventing adverse cardiovascular events. Intensified efforts to treat hypertension aggressively in patients with PAD therefore seem justified, particularly because diabetes is a strong predictor . . . [Full Text of this Article]