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 .
The effect of diabetes on outcomes of patients with advanced heart failure in the BEST trial.
OBJECTIVES This was a retrospective analysis to determine the effect of diabetes on outcome in patients with advanced heart failure ( HF ) , and to determine the effect of beta-blockade in patients with HF with and without diabetes mellitus . BACKGROUND In chronic HF the impact on clinical outcomes and therapeutic response of the prevalent comorbid condition diabetes mellitus has not been extensively investigated . METHODS We assessed the impact of diabetes on prognosis and effectiveness of beta-blocker therapy with bucindolol in patients with HF enrolled in the Beta-Blocker Evaluation of Survival Trial ( BEST ) . We conducted a retrospective analysis to examine the prognosis of patients with advanced HF with and without diabetes , and the effect of beta-blocker therapy on mortality and HF progression or myocardial infa rct ion ( MI ) . The data base was the 2,708 patients with advanced HF ( 36 % with diabetes and 64 % without diabetes ) who were r and omized to the beta-blocker bucindolol or placebo in BEST and followed for mortality , hospitalization , and MI for an average of two years . RESULTS Patients with diabetes had more severe chronic HF  and more coronary risk factors than patients without diabetes . Diabetes was independently associated with increased mortality in patients with ischemic cardiomyopathy ( adjusted hazard ratio 1.33 , 95 % confidence interval 1.12 to 1.58 , p = 0.001 ) , but not in those with a nonischemic etiology ( adjusted hazard ratio 0.98 , 95 % confidence interval 0.74 to 1.30 , p = 0.89 ) . Compared with patients without diabetes , in diabetic patients beta-blocker therapy was at least as effective in reducing death or HF hospitalizations , total hospitalizations , HF hospitalizations , and MI . Ventricular function and physiologic responses to beta-blockade were similar in patients with and without diabetes . CONCLUSIONS Diabetes worsens prognosis in patients with advanced HF , but this worsening appears to be limited to patients with ischemic cardiomyopathy . In advanced HF beta-blockade is effective in reducing major clinical end points in patients with and without diabetes
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 .