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
The genes are not to blame
20.07.2018 | Technische Universität München
Targeting headaches and tumors with nano-submarines
20.07.2018 | Universitätsmedizin der Johannes Gutenberg-Universität Mainz
A new manufacturing technique uses a process similar to newspaper printing to form smoother and more flexible metals for making ultrafast electronic devices.
The low-cost process, developed by Purdue University researchers, combines tools already used in industry for manufacturing metals on a large scale, but uses...
For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.
To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...
For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.
Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...
Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.
A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...
Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.
"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....
13.07.2018 | Event News
12.07.2018 | Event News
03.07.2018 | Event News
20.07.2018 | Power and Electrical Engineering
20.07.2018 | Information Technology
20.07.2018 | Materials Sciences