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Do you know what hypertension means?

Although it might sound like it refers to someone who is very, very tense, it is actually just the medical term for high blood pressure (BP).  The current standards of diabetes care from the American Diabetes Association indicate that for people with diabetes and hypertension, the goal is:

  • Systolic (top number) BP less than 140
  • Diastolic (bottom number) BP less than 90 (typically indicated as 140/90).

For some people with diabetes who have additional risk, a BP goal less than 130/80 might be appropriate.

  • Previous versions of the standards of care gave a goal of less than 130/80 for all with diabetes, so the current recommendation actually represents a relaxation of the BP goals.

Towards the end of 2015, results from the SPRINT trial were released.

SPRINT stands for Systolic Blood Pressure Intervention Trial, and it was published in the New England Journal of Medicine The results from this show that a lower systolic BP of less than 120 was associated with lower rates of death and adverse cardiovascular events in high-risk patients.  High blood pressure is very common, and there has long been a strong relationship between blood pressure and cardiovascular risk.  We know that lowering an elevated blood pressure reduces risk, and yet the big question is how low should we try to get the BP?  The SPRINT trial looked at the effect of lowering BP more than what is recommended by most current guidelines.

The trial included:

  • 9,361 participants
  • Age – minimum of 50 years old
  • Participants had treated or untreated systolic BP of 130-180
  • Participants had at least one additional cardiovascular risk factor
    • Additional risk factors included: cardiovascular disease, chronic kidney disease, a Framingham Risk Score of at least 15% for 10-year cardiovascular disease risk, or an age of at least 75 years.
    • People with diabetes or previous stroke were excluded from the study.