The associations between BP-lowering treatments and outcomes were not significantly different , irrespective of drug class , except for stroke and heart failure .
AND RELEVANCE Among patients with type 2 diabetes , BP lowering was associated with improved mortality and other clinical outcomes with lower RRs observed among those with baseline BP of 140 mm Hg and greater .
These findings support the use of medications for BP lowering in these patients
IMPORTANCE Lowering blood pressure ( BP ) is widely used to reduce vascular risk in individuals with diabetes .
OBJECTIVE To determine the associations between BP-lowering treatment and vascular disease in type 2 diabetes .
Effects of the early administration of enalapril on mortality in patients with acute myocardial infarction. Results of the Cooperative New Scandinavian Enalapril Survival Study II (CONSENSUS II)
BACKGROUND Long-term administration of angiotensin-converting -- enzyme ( ACE ) inhibitors has been shown to improve survival in patients with symptomatic left ventricular failure and to attenuate left ventricular dilatation in patients with myocardial infa rct ion . We studied whether mortality could be reduced during the 6 months after an acute myocardial infa rct ion with use of the ACE inhibitor enalapril . METHODS At 103 Sc and inavian centers patients with acute myocardial infa rct ions and blood pressure above 100/60 mm Hg were r and omly assigned to treatment with either enalapril or placebo , in addition to conventional therapy . Therapy was initiated with an intravenous infusion of enalapril ( enalaprilat ) within 24 hours after the onset of chest pain , followed by administration of oral enalapril . RESULTS Of the 6090 patients enrolled , 3046 were assigned to  placebo and 3044 to enalapril . The life-table mortality rates in the two groups at one and six months were not significantly different ( 6.3 and 10.2 percent in the placebo group vs. 7.2 and 11.0 percent in the enalapril group , P = 0.26 ) . The relative risk of death in the enalapril group was 1.10 ( 95 percent confidence interval , 0.93 to 1.29 ) . Death due to progressive heart failure occurred in 104 patients ( 3.4 percent ) in the placebo group and 132 ( 4.3 percent ) in the enalapril group ( P = 0.06 ) . Therapy had to be changed because of worsening heart failure in 30 percent of the placebo group and 27 percent of the enalapril group ( P less than 0.006 ) . Early hypotension ( systolic pressure less than 90 mm Hg or diastolic pressure less than 50 mm Hg ) occurred in 12 percent of the enalapril group and 3 percent of the placebo group ( P less than 0.001 ) . CONCLUSIONS Enalapril therapy started within 24 hours of the onset of acute myocardial infa rct ion does not improve survival during the 180 days after infa rct ion
The associations between BP-lowering treatments and outcomes were not significantly different , irrespective of drug class , except for stroke and heart failure .
AND RELEVANCE Among patients with type 2 diabetes , BP lowering was associated with improved mortality and other clinical outcomes with lower RRs observed among those with baseline BP of 140 mm Hg and greater .
These findings support the use of medications for BP lowering in these patients
IMPORTANCE Lowering blood pressure ( BP ) is widely used to reduce vascular risk in individuals with diabetes .
OBJECTIVE To determine the associations between BP-lowering treatment and vascular disease in type 2 diabetes .