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Intensive versus routine blood pressure control in patients with type 2 diabetes: A Meta-analysis and Trial
Jibran Ikram1,2, Aizaz Ali3, Sundus Huma3
1Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Ohio.
Journal of Hypertension
|February 9, 2026
Summary
Intensive blood pressure control in type 2 diabetes significantly reduces stroke risk. However, evidence for benefits on mortality and heart failure remains inconclusive, requiring further investigation.
Area of Science:
- Cardiology
- Endocrinology
- Clinical Research
Background:
- Blood pressure (BP) targets for type 2 diabetes are debated.
- Intensive BP control benefits cardiovascular health in general populations but not definitively in diabetes.
Purpose of the Study:
- To systematically review and meta-analyze randomized controlled trials on intensive BP control in type 2 diabetes.
- To assess the net benefit of intensive BP control versus routine control on cardiovascular outcomes.
Main Methods:
- Systematic review and meta-analysis of 11 randomized controlled trials (24,308 participants).
- Searched PubMed, Embase, and Cochrane CENTRAL through November 2024.
- Used random-effects meta-analysis and trial sequential analysis (TSA) to evaluate evidence robustness.
Main Results:
- Intensive BP control (target <130/80 mmHg) significantly reduced stroke risk (RR: 0.64; 95% CI: 0.51-0.81).
- A trend towards reduced major cardiovascular events was observed (RR: 0.86; 95% CI: 0.72-1.03).
- No significant differences were found in mortality or heart failure hospitalization.
Conclusions:
- Intensive BP control provides firm evidence for stroke reduction in type 2 diabetes.
- The impact on mortality and heart failure requires further study due to inconclusive TSA results.
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