CONCLUSIONS Antihypertensive treatment reduces the risk of mortality and cardiovascular morbidity in people with diabetes mellitus and a systolic blood pressure more than 140 mm Hg .
If systolic blood pressure is less than 140 mm Hg , however , further treatment is associated with an increased risk of cardiovascular death , with no observed benefit
OBJECTIVE To assess the effect of antihypertensive treatment on mortality and cardiovascular morbidity in people with diabetes mellitus , at different blood pressure levels .
Aggressive Blood Pressure Control Increases Coronary Heart Disease Risk Among Diabetic Patients
OBJECTIVE Blood pressure control can reduce the risk of coronary heart disease ( CHD ) among diabetic patients ; however , it is not known whether the lowest risk of CHD is among diabetic patients with the lowest blood pressure level . RESEARCH DESIGN AND METHODS We performed a prospect i ve cohort  study ( 2000–2009 ) on diabetic patients including 17,536 African Americans and 12,618 whites . Cox proportional hazards regression models were used to estimate the association of blood pressure with CHD risk . RESULTS During a mean follow-up of 6.0 years , 7,260 CHD incident cases were identified . The multivariable-adjusted hazard ratios of CHD associated with different levels of systolic/diastolic blood pressure at baseline ( < 110/65 , 110–119/65–69 , 120–129/70–80 , and 130–139/80–90 mmHg [ reference group ] ; 140–159/90–100 ; and ≥160/100 mmHg ) were 1.73 , 1.16 , 1.04 , 1.00 , 1.06 , and 1.11 ( P trend < 0.001 ) , respectively , for African American diabetic patients , and 1.60 , 1.27 , 1.08 , 1.00 , 0.95 , and 0.99 ( P trend<0.001 ) for white diabetic patients , respectively . A U-shaped association of isolated systolic and diastolic blood pressure at baseline as well as blood pressure during follow-up with CHD risk was observed among both African American and white diabetic patients ( all Ptrend < 0.001 ) . The U-shaped association was present in the younger age-group ( 30–49 years ) , and this U-shaped association changed to an inverse association in the older age-group ( ≥60 years ) . CONCLUSIONS Our study suggests that there is a U-shaped or inverse association between blood pressure and the risk of CHD , and aggressive blood pressure control ( blood pressure < 120/70 mmHg ) is associated with an increased risk of CHD among both African American and white patients with diabetes
CONCLUSIONS Antihypertensive treatment reduces the risk of mortality and cardiovascular morbidity in people with diabetes mellitus and a systolic blood pressure more than 140 mm Hg .
If systolic blood pressure is less than 140 mm Hg , however , further treatment is associated with an increased risk of cardiovascular death , with no observed benefit
OBJECTIVE To assess the effect of antihypertensive treatment on mortality and cardiovascular morbidity in people with diabetes mellitus , at different blood pressure levels .