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
Collagen nanofibrils in mammalian tissues get stronger with exercise
14.12.2018 | University of Illinois College of Engineering
New discoveries predict ability to forecast dementia from single molecule
12.12.2018 | UT Southwestern Medical Center
The more objects we make "smart," from watches to entire buildings, the greater the need for these devices to store and retrieve massive amounts of data quickly without consuming too much power.
Millions of new memory cells could be part of a computer chip and provide that speed and energy savings, thanks to the discovery of a previously unobserved...
What if, instead of turning up the thermostat, you could warm up with high-tech, flexible patches sewn into your clothes - while significantly reducing your...
A widely used diabetes medication combined with an antihypertensive drug specifically inhibits tumor growth – this was discovered by researchers from the University of Basel’s Biozentrum two years ago. In a follow-up study, recently published in “Cell Reports”, the scientists report that this drug cocktail induces cancer cell death by switching off their energy supply.
The widely used anti-diabetes drug metformin not only reduces blood sugar but also has an anti-cancer effect. However, the metformin dose commonly used in the...
A research team from the University of Zurich has developed a new drone that can retract its propeller arms in flight and make itself small to fit through narrow gaps and holes. This is particularly useful when searching for victims of natural disasters.
Inspecting a damaged building after an earthquake or during a fire is exactly the kind of job that human rescuers would like drones to do for them. A flying...
Over the last decade, there has been much excitement about the discovery, recognised by the Nobel Prize in Physics only two years ago, that there are two types...
12.12.2018 | Event News
10.12.2018 | Event News
06.12.2018 | Event News
14.12.2018 | Power and Electrical Engineering
14.12.2018 | Physics and Astronomy
14.12.2018 | Physics and Astronomy