Angeli Fabio, Verdecchia Paolo, Reboldi Gianpaolo
Section of Cardiology, Hospital Media Valle del Tevere, AUSL 2 dell'Umbria, Perugia, Italy.
Expert Rev Cardiovasc Ther. 2012 Dec;10(12):1467-70. doi: 10.1586/erc.12.151.
In the ACCORD clinical trial, lowering blood pressure (BP) to normal levels, below currently recommended levels, did not significantly reduce the combined risk of fatal or nonfatal cardiovascular (CV) disease events in adults with Type 2 diabetes. A new post hoc analysis of the same trial also suggests that lowering BP in centrally obese diabetic patients is not a useful means for CV prevention. The authors discuss these findings in the light of accumulated evidence on the relationship between the degree of BP reduction and the risk of CV events in patients with diabetes. In particular, the authors focus on trial and systematic review findings, suggesting that a more intensive reduction of BP in Type 2 diabetes effectively protects from stroke.
在控制糖尿病患者心血管风险行动（ACCORD）临床试验中，将血压降至目前推荐水平以下的正常水平，并未显著降低2型糖尿病成年患者发生致命或非致命心血管疾病事件的综合风险。对同一试验的一项新的事后分析还表明，降低中心性肥胖糖尿病患者的血压并非预防心血管疾病的有效手段。作者根据关于血压降低程度与糖尿病患者心血管事件风险之间关系的累积证据讨论了这些发现。特别是，作者关注试验和系统评价结果，这些结果表明，在2型糖尿病患者中更强化地降低血压可有效预防中风。
