The Swedish National Board of Health and Welfare recently raised the recommended target blood pressure for patients with diabetes. This may lead to more patients suffering from stroke or heart attack, according to a new study from the Sahlgrenska Academy. The new study is the world’s largest on the subject and is based on data from the National Diabetes Register.
In February 2015, the Swedish National Board of Health and Welfare raised the recommended goal for systolic blood pressure (blood pressure when the heart is contracting) in their guidelines for diabetes care.
Recommended blood pressure targets for diabetes are being challenged
University of Gothenburg
The target blood pressure was raised from the previous level of below 130 mm Hg to below 140 mm Hg. The recommended target is important for how intensive antihypertensive treatment should be in patients with diabetes.
The background for the revised recommendation was research suggesting that not only high blood pressure values, but also values below 130 mm Hg could lead to increased morbidity from cardiovascular diseases.
The researchers behind the new study are questioning this. Their study shows a linear relationship between blood pressure and cardiovascular disease. The lower the blood pressure, the fewer cases of stroke and myocardial infarction, even at the lowest levels.
“We believe that the recommendation to accept higher blood pressure in patients with diabetes is incorrect. It may lead to more cases of stroke and myocardial infarction in this patient group,” said Staffan Björck, Associate Professor of Nephrology at Sahlgrenska Academy, University of Gothenburg and one of the researchers behind the study.
The new study is based on data from the National Diabetes Register, the Patient Register and the Prescribed Drug Register. It covers 187,000 patients with type 2 diabetes, who were followed for an average of 5 years.
The main difference between this study and the studies on which the Swedish National Board of Health and Welfare based its recommendations is that patients who already suffered from serious diseases were not included in the new study.
“What we have seen in our study is that, if we exclude individuals with previous severe disease, then the connection between low blood pressure and increased risk of stroke and myocardial infarction disappears,” said Samuel Adamsson Eryd, MD, the primary author of the study.
There is a natural explanation for this.
“If patients with diseases that can cause low blood pressure are also included in a study, the overall interpretation might be that low blood pressure leads to more cardiovascular disease,” said Staffan Björck.
300,000 patients in Sweden
There are approximately 300,000 patients with diabetes in Sweden, but they are not the only ones affected by the revised blood pressure targets. Both European and American expert organizations have raised the recommended goal for systolic blood pressure to below 140 mm Hg. As the new study is much larger than all previous studies on the topic, it is important for discussions of blood pressure targets, both in Sweden and abroad.
The study Blood pressure and complications in individuals with type 2 diabetes and no previous cardiovascular disease: national population based cohort study was published in BMJ on August 4.
Link to article: http://www.bmj.com/content/354/bmj.i4070.long
Staffan Björck, Associate Professor at Sahlgrenska Academy, University of Gothenburg
Samuel Adamsson Eryd, researcher at Sahlgrenska Academy, University of Gothenburg
Henrik Axlid | idw - Informationsdienst Wissenschaft
Laser activated gold pyramids could deliver drugs, DNA into cells without harm
24.03.2017 | Harvard John A. Paulson School of Engineering and Applied Sciences
What does congenital Zika syndrome look like?
24.03.2017 | University of California - San Diego
Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.
The results will be published on March 22 in the journal „Astronomy & Astrophysics“.
Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...
Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.
Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...
In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...
20.03.2017 | Event News
14.03.2017 | Event News
07.03.2017 | Event News
24.03.2017 | Materials Sciences
24.03.2017 | Physics and Astronomy
24.03.2017 | Physics and Astronomy