Endocrine · 2022
Intensive vs. conventional blood pressure goals in older patients with type 2 diabetes: a systematic review and meta-analysis.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод пока не подготовлен
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Rodriguez-Gutierrez Rene, Flores-Rodríguez Andrea, Raygoza-Cortez Karina, Garcia-Leal Mariana, Mariño-Velasco Sofía, Plata-Huerta Hiram H, Sáenz-Flores Melissa, Ramirez-Garcia Luz A, Rojo-Garza Amanda, Maraka Spyridoula, Singh-Ospina Naikky V, Brito Juan P, Gonzalez-Gonzalez Jose G
Аннотация
PURPOSE: Assess the effect of intensive vs conventional blood pressure goals on patient-important outcomes in older adults with type 2 diabetes.
METHODS: A comprehensive search was performed using electronic databases. Randomized controlled trials comparing intensive vs conventional blood pressure goals in adults over 60 years of age with type 2 diabetes were included. Events were evaluated using a modified Mantel-Haenszel meta-analysis with Peto's method. Study selection and data extraction were performed independently and in duplicate.
RESULTS: Seven trials were included. A 19% risk reduction (OR 0.81; 95% CI 0.69-0.95; I2 = 8%; p = 0.35) in the occurrence of major adverse cardiovascular events (MACE) and 37% risk reduction (OR 0.63; 95% CI 0.51-0.79; I2 = 0%; p = 0.56) in the occurrence of fatal or non-fatal stroke was documented in the intensive treatment group. There were no differences in the occurrence of all-cause mortality, cardiovascular mortality, non-fatal myocardial infarction, and peripheral vascular disease. Data regarding treatment adverse effects and microvascular outcomes was scarce.
CONCLUSIONS: Intensive blood pressure goals in older patients with diabetes were associated with a lower risk of stroke and MACE, but not with all-cause mortality, cardiovascular mortality, non-fatal myocardial infarction, and peripheral vascular disease.
METHODS: A comprehensive search was performed using electronic databases. Randomized controlled trials comparing intensive vs conventional blood pressure goals in adults over 60 years of age with type 2 diabetes were included. Events were evaluated using a modified Mantel-Haenszel meta-analysis with Peto's method. Study selection and data extraction were performed independently and in duplicate.
RESULTS: Seven trials were included. A 19% risk reduction (OR 0.81; 95% CI 0.69-0.95; I2 = 8%; p = 0.35) in the occurrence of major adverse cardiovascular events (MACE) and 37% risk reduction (OR 0.63; 95% CI 0.51-0.79; I2 = 0%; p = 0.56) in the occurrence of fatal or non-fatal stroke was documented in the intensive treatment group. There were no differences in the occurrence of all-cause mortality, cardiovascular mortality, non-fatal myocardial infarction, and peripheral vascular disease. Data regarding treatment adverse effects and microvascular outcomes was scarce.
CONCLUSIONS: Intensive blood pressure goals in older patients with diabetes were associated with a lower risk of stroke and MACE, but not with all-cause mortality, cardiovascular mortality, non-fatal myocardial infarction, and peripheral vascular disease.