Current Cardiology Reports

, Volume 14, Issue 1, pp 89–96

Tight Blood Pressure Control in Diabetes: Evidence-Based Review of Treatment Targets in Patients with Diabetes

  • Gianpaolo Reboldi
  • Giorgio Gentile
  • Valeria Maria Manfreda
  • Fabio Angeli
  • Paolo Verdecchia
Diabetes and Cardiovascular Disease (ND Wong, Section Editor)

DOI: 10.1007/s11886-011-0236-8

Cite this article as:
Reboldi, G., Gentile, G., Manfreda, V.M. et al. Curr Cardiol Rep (2012) 14: 89. doi:10.1007/s11886-011-0236-8


Blood pressure (BP) targets in diabetic patients stills represent the object of a major debate, fueled by the recent publication of post hoc observational analyses of the INVEST and the ONTARGET trials, suggesting an increased risk of cardiovascular events with tighter control, the J-curve effect, and by the results of the ACCORD trial, showing no improvements in the composite primary outcome of nonfatal myocardial infarction, stroke, or cardiovascular death in the intensive BP-lowering arm (<120/80 mmHg). In the present review, we focus on existing evidence about different BP targets in diabetic subjects and we present the results of our recent meta-analysis, showing that tight BP control may significantly reduce the risk of stroke in these patients without increasing the risk of myocardial infarction. Therapeutic inertia (leaving diabetic patients with BP values of 140/90 mmHg or higher) should be avoided at all costs, as this would lead to an unacceptable toll in terms of human lives, suffering, and socioeconomic costs.


Diabetes mellitusHypertensionStrokeMyocardial infarctionCardiovascular diseasesEvidence-based medicineEvidence-based practiceBlood pressure control

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Hypertension Optimal Treatment


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Multiple Risk Factor Intervention Trial


Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial


Randomized Olmesartan and Diabetes Microalbuminuria Prevention


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UK Prospective Diabetes Study

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Gianpaolo Reboldi
    • 1
  • Giorgio Gentile
    • 1
  • Valeria Maria Manfreda
    • 2
  • Fabio Angeli
    • 3
  • Paolo Verdecchia
    • 4
  1. 1.Department of Internal MedicineUniversity of PerugiaPerugiaItaly
  2. 2.Nephrology and Dialysis Unit, Bolognini HospitalSeriateItaly
  3. 3.Division of Cardiology, Hospital S. Maria della MisericordiaPerugiaItaly
  4. 4.Division of Internal Medicine, Hospital of AssisiAssisiItaly