Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

UF researcher urges caution in reducing blood pressure in patients with diabetes, coronary disease

15.03.2010
For patients with diabetes and heart disease, less isn't always more — at least when it comes to blood pressure.

New data show an increased risk of heart attack, stroke or death for patients having blood pressure deemed too high — or too low, according to Rhonda Cooper-DeHoff, Pharm.D., an associate professor of pharmacy and medicine at UF. She reported her findings today (Sunday, March 14) at the American College of Cardiology's 59th annual scientific session in Atlanta.

She recommends raising the systolic bar above 120 for blood pressure in patients with diabetes and coronary artery disease, saying that levels between 130 and 140 appear to be the most healthful.

Based on hypertension treatment guidelines, health-care practitioners have assumed that with regard to blood pressure, "the lower, the better," Cooper-DeHoff said. But, The International Verapamil SR-Trandolapril study, known as INVEST, suggests that the range considered normal for healthy Americans may actually be risky for those with a combined diagnosis of diabetes and coronary artery disease.

"Our data suggest that in patients with both diabetes and coronary artery disease, there is a blood pressure threshold below which cardiovascular risk increases," Cooper-DeHoff said.

As many as two out of three adults with diabetes have high blood pressure. Normal blood pressure as defined by the American Heart Association is less than 120 systolic and less than 80 diastolic. Blood pressure greater than 140 is still associated with a nearly 50 percent increase in cardiovascular risk in patients with diabetes. But efforts to reduce systolic blood pressure to below 130 did not appear to offer any additional benefit to diabetics with coronary artery disease compared with reduction of systolic blood pressure to between 130 and less than 140.

Cooper-DeHoff's study reveals for the first time that this group of patients also had a similar increase in risk when their blood pressure was controlled to lower than 115 systolic — the range recommended as normal by the American Heart Association.

Stephan Brietzke, M.D., an endocrinologist who did not participate in the research, was intrigued by the findings, saying that they parallel recent studies looking at blood sugar control, which suggest a U-shaped curve with higher cardiovascular risks at both "too high" and "too low" extremes.

Brietzke, an associate professor of clinical medicine at the University of Missouri-Columbia since 2002, led a multidisciplinary team that developed Veterans Health Administration and Department of Defense collaborative guidelines for the treatment of type 2 diabetes. He sees this as an important study for doctors treating patients with diabetes and cardiovascular disease.

"Identifying thresholds of when to initiate treatment, and when to say 'good enough,' is extremely important not only to optimize patient outcomes, but also to help reduce unnecessary costs of care," Brietzke said.

The AHA reports that heart disease or stroke is the top cause of death for people with diabetes, affecting more than 60 percent of patients. High blood pressure, common in diabetes, doubles the risk of cardiovascular disease.

The INVEST study is the first to evaluate the effects of blood pressure-lowering in diabetic patients diagnosed with coronary artery disease. Researchers analyzed data collected from 6,400 patients from fall 1997 to spring 2003. The patients, who were 50 or older, were recruited from more than 850 sites in 14 countries. The researchers further consulted the national death index for U.S.-enrolled patients for an additional five years to compare death rates of patients based on their blood pressure category ranging from tightly controlled to non-controlled hypertension.

Abbott Laboratories provided funding for INVEST. Cooper-DeHoff also received support from a National Institutes of Health career development award.

Linda Homewood | EurekAlert!
Further information:
http://www.ufl.edu

More articles from Health and Medicine:

nachricht Biofilm discovery suggests new way to prevent dangerous infections
23.05.2017 | University of Texas at Austin

nachricht Another reason to exercise: Burning bone fat -- a key to better bone health
19.05.2017 | University of North Carolina Health Care

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Turmoil in sluggish electrons’ existence

An international team of physicists has monitored the scattering behaviour of electrons in a non-conducting material in real-time. Their insights could be beneficial for radiotherapy.

We can refer to electrons in non-conducting materials as ‘sluggish’. Typically, they remain fixed in a location, deep inside an atomic composite. It is hence...

Im Focus: Wafer-thin Magnetic Materials Developed for Future Quantum Technologies

Two-dimensional magnetic structures are regarded as a promising material for new types of data storage, since the magnetic properties of individual molecular building blocks can be investigated and modified. For the first time, researchers have now produced a wafer-thin ferrimagnet, in which molecules with different magnetic centers arrange themselves on a gold surface to form a checkerboard pattern. Scientists at the Swiss Nanoscience Institute at the University of Basel and the Paul Scherrer Institute published their findings in the journal Nature Communications.

Ferrimagnets are composed of two centers which are magnetized at different strengths and point in opposing directions. Two-dimensional, quasi-flat ferrimagnets...

Im Focus: World's thinnest hologram paves path to new 3-D world

Nano-hologram paves way for integration of 3-D holography into everyday electronics

An Australian-Chinese research team has created the world's thinnest hologram, paving the way towards the integration of 3D holography into everyday...

Im Focus: Using graphene to create quantum bits

In the race to produce a quantum computer, a number of projects are seeking a way to create quantum bits -- or qubits -- that are stable, meaning they are not much affected by changes in their environment. This normally needs highly nonlinear non-dissipative elements capable of functioning at very low temperatures.

In pursuit of this goal, researchers at EPFL's Laboratory of Photonics and Quantum Measurements LPQM (STI/SB), have investigated a nonlinear graphene-based...

Im Focus: Bacteria harness the lotus effect to protect themselves

Biofilms: Researchers find the causes of water-repelling properties

Dental plaque and the viscous brown slime in drainpipes are two familiar examples of bacterial biofilms. Removing such bacterial depositions from surfaces is...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

AWK Aachen Machine Tool Colloquium 2017: Internet of Production for Agile Enterprises

23.05.2017 | Event News

Dortmund MST Conference presents Individualized Healthcare Solutions with micro and nanotechnology

22.05.2017 | Event News

Innovation 4.0: Shaping a humane fourth industrial revolution

17.05.2017 | Event News

 
Latest News

Scientists propose synestia, a new type of planetary object

23.05.2017 | Physics and Astronomy

Zap! Graphene is bad news for bacteria

23.05.2017 | Life Sciences

Medical gamma-ray camera is now palm-sized

23.05.2017 | Medical Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>