Related Experiment Videos

Diastolic pressure in type 2 diabetes: can target systolic pressure be reached without "diastolic hypotension"?

Etty Osher1, Naftali Stern

  • 1Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Diabetes Care
|February 15, 2008
PubMed

Insights

Lowering systolic blood pressure in diabetes to below 130 mmHg may excessively reduce diastolic pressure. This intensive blood pressure management requires careful consideration of risks, especially for older diabetic patients or those with coronary artery disease.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Hypertension Research

Background:

  • The target for systolic blood pressure in diabetes is often set below 130 mmHg.
  • Diabetic patients exhibit distinct blood pressure profiles compared to non-diabetic individuals, including higher pulse pressure.

Purpose of the Study:

  • To evaluate the practicality and outcomes of aggressively lowering systolic blood pressure (SBP) to <130 mmHg in diabetic patients.
  • To assess the impact of intensive blood pressure titration on diastolic blood pressure (DBP) in this population.

Main Methods:

  • A clinical practice study involving 257 diabetic patients.
  • Blood pressure was titrated to target <130/85 mmHg using Joint National Committee VI guidelines.
  • Analysis of baseline and achieved blood pressure, including patient demographics and comorbidities.

Main Results:

  • Target systolic pressure (<130 mmHg) was achieved in only one-third of diabetic patients.
  • In 57% of patients, the achieved diastolic pressure was < or = 70 mmHg.
  • Patients with lower final DBP were older, had more coronary artery disease, and higher initial pulse pressures.

Conclusions:

  • Aggressively lowering SBP in diabetic patients is associated with a significant risk of excessive DBP reduction.
  • The benefits of tight systolic control (<130 mmHg) versus the risks of excessive diastolic reduction remain unresolved, particularly for high-risk subgroups.
  • Further research is needed to determine optimal blood pressure targets for diabetic patients, balancing SBP and DBP control.

Related Concept Videos

Hypertension I: Introduction01:28

Hypertension I: Introduction

Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
Alterations in Blood Pressure01:30

Alterations in Blood Pressure

Alterations in blood pressure, such as hypertension (high blood pressure) and hypotension (low blood pressure), significantly affect human health. Understanding these conditions' classifications, causes, and symptoms is essential for effective management and treatment.
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart beats)...
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
Type II Diabetes II: Pathophysiology01:24

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.
Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis01:25

Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis

Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
Blood Pressure01:24

Blood Pressure

The movement of blood in a human body, commonly referred to as blood flow, is determined by the volume of blood that traverses a certain section of the bodily system per unit time. It is the rhythmic contraction of the heart's ventricles that primarily instigates this movement. As the ventricles contract, blood is forced into the prominent arteries, which then flow from areas of greater pressure to lower pressure areas. This movement continues into smaller arteries and arterioles and...