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 .
Mortality findings for stepped-care and referred-care participants in the hypertension detection and follow-up program, stratified by other risk factors. The Hypertension Detection and Follow-up Program Cooperative Research Group.
Analyses of 5-year mortality data from the  Hypertension Detection and Follow-up Program ( HDFP )  were performed with stratification according to several baseline traits . The HDFP participants were 10,940 white and black men and women ages 30 - 69 at baseline who were r and omized to either stepped-care ( SC ) or referred-care  ( RC ) groups . All-causes mortality rates were lower for the SC than the RC group , both overall and for the 90 - 104 mm Hg stratum , for both cigarette smokers and nonsmokers , and for persons with and without hypercholesterolemia , hyperglycemia , diagnosed diabetes , hyperuricemia , or rapid pulse rate . The SC group also fared better than RC for all strata of body mass index , with an apparent trend toward an inverse relationship between body mass index and degree of benefit . Several of the traits -- cigarette smoking , fasting hyperglycemia , and hyperuricemia -- were associated with significantly higher 5-year mortality rates in both SC and RC participants , in both univariate and multivariate analyses , and a significant U-shaped relationship was recorded between body mass index and mortality for both SC and RC groups . These findings indicate the broad benefit of vigorous antihypertensive stepped-care treatment for hypertensive patients regardless of the presence or absence of the other major risk factors . They also underscore the need for comprehensive management of persons with high blood pressure to control not only their hypertension but also other risk factors associated with negative impact on long-term prognosis
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 .