BMJ 1998;317:703-713 ( 12 September )

Papers

Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38

Editorials by Orchard and Mogensen Papers pp   713 , 720 This paper was prepared for publication by Robert Turner, Rury Holman, Irene Stratton, Carole Cull, Valeria Frighi, Susan Manley, David Matthews, Andrew Neil, Heather McElroy, Eva Kohner, Charles Fox, David Hadden, and David Wright.

UK Prospective Diabetes Study Group. 

Correspondence to: Professor R Turner, UK Prospective Diabetes Study Group, Diabetes Research Laboratories, Radcliffe Infirmary, Oxford OX2 6HE

Objective: To determine whether tight control of blood pressure prevents macrovascular and microvascular complications in patients with type 2 diabetes.
Design: Randomised controlled trial comparing tight control of blood pressure aiming at a blood pressure of <150/85 mm Hg (with the use of an angiotensin converting enzyme inhibitor captopril or a beta  blocker atenolol as main treatment) with less tight control aiming at a blood pressure of <180/105 mm Hg.
Setting: 20 hospital based clinics in England, Scotland, and Northern Ireland.
Subjects: 1148 hypertensive patients with type 2 diabetes (mean age 56, mean blood pressure at entry 160/94 mm Hg); 758 patients were allocated to tight control of blood pressure and 390 patients to less tight control with a median follow up of 8.4 years.
Main outcome measures: Predefined clinical end points, fatal and non-fatal, related to diabetes, deaths related to diabetes, and all cause mortality. Surrogate measures of microvascular disease included urinary albumin excretion and retinal photography.
Results: Mean blood pressure during follow up was significantly reduced in the group assigned tight blood pressure control (144/82 mm Hg) compared with the group assigned to less tight control (154/87 mm Hg) (P<0.0001). Reductions in risk in the group assigned to tight control compared with that assigned to less tight control were 24% in diabetes related end points (95% confidence interval 8% to 38%) (P=0.0046), 32% in deaths related to diabetes (6% to 51%) (P=0.019), 44% in strokes (11% to 65%) (P=0.013), and 37% in microvascular end points (11% to 56%) (P=0.0092), predominantly owing to a reduced risk of retinal photocoagulation. There was a non-significant reduction in all cause mortality. After nine years of follow up the group assigned to tight blood pressure control also had a 34% reduction in risk in the proportion of patients with deterioration of retinopathy by two steps (99% confidence interval 11% to 50%) (P=0.0004) and a 47% reduced risk (7% to 70%) (P=0.004) of deterioration in visual acuity by three lines of the early treatment of diabetic retinopathy study (ETDRS) chart. After nine years of follow up 29% of patients in the group assigned to tight control required three or more treatments to lower blood pressure to achieve target blood pressures.
Conclusion: Tight blood pressure control in patients with hypertension and type 2 diabetes achieves a clinically important reduction in the risk of deaths related to diabetes, complications related to diabetes, progression of diabetic retinopathy, and deterioration in visual acuity.

Key messages

  • This study showed that tight control of blood pressure based on captopril or atenolol as first agents and aiming for both a systolic blood pressure <150 mm Hg and diastolic pressure <85 mm Hg achieved a mean 144/82 mm Hg compared with 154/87 mm Hg in a control group

  • 29% of patients in the tight control group required three or more hypotensive treatments

  • Tight control of blood pressure reduced the risk of any non-fatal or fatal diabetic complications and of death related to diabetes; deterioration in visual acuity was also reduced

  • Reducing blood pressure needs to have high priority in caring for patients with type 2 diabetes



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  • Kern, T. S., Barber, A. J. (2008). Retinal ganglion cells in diabetes. J. Physiol. 586: 4401-4408 [Abstract] [Full text]  
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  • Agwu, J C. (2008). Screening for type 2 diabetes mellitus in children and adolescents. British Journal of Diabetes & Vascular Disease 8: 163-168 [Abstract]  
  • Pearce, K. A., Love, M. M., Shelton, B. J., Schoenberg, N. E., Williamson, M. A., Barron, M. A., Houlihan, J. M. (2008). Cardiovascular Risk Education and Social Support (CaRESS): Report of a Randomized Controlled Trial from the Kentucky Ambulatory Network (KAN). J Am Board Fam Med 21: 269-281 [Abstract] [Full text]  
  • Dokken, B. B. (2008). The Parodox of Glycemic Control and Cardiovascular Complications: Sorting Out the Data. Diabetes Spectr. 21: 150-152 [Full text]  
  • U.S. Preventive Services Task Force, (2008). Screening for Type 2 Diabetes Mellitus in Adults: U.S. Preventive Services Task Force Recommendation Statement. ANN INTERN MED 148: 846-854 [Abstract] [Full text]  
  • Bloomgarden, Z. T. (2008). Cardiovascular Disease in Diabetes. Diabetes Care 31: 1260-1266 [Full text]  
  • Shen, L. Q., Child, A., Weber, G. M., Folkman, J., Aiello, L. P. (2008). Rosiglitazone and Delayed Onset of Proliferative Diabetic Retinopathy. Arch Ophthalmol 126: 793-799 [Abstract] [Full text]  
  • Vallance, J. H., Wilson, P. J., Leese, G. P., McAlpine, R., MacEwen, C. J., Ellis, J. D. (2008). Diabetic Retinopathy: More Patients, Less Laser: A longitudinal population-based study in Tayside, Scotland. Diabetes Care 31: 1126-1131 [Abstract] [Full text]  
  • Schocken, D. D., Benjamin, E. J., Fonarow, G. C., Krumholz, H. M., Levy, D., Mensah, G. A., Narula, J., Shor, E. S., Young, J. B., Hong, Y. (2008). Prevention of Heart Failure: A Scientific Statement From the American Heart Association Councils on Epidemiology and Prevention, Clinical Cardiology, Cardiovascular Nursing, and High Blood Pressure Research; Quality of Care and Outcomes Research Interdisciplinary Working Group; and Functional Genomics and Translational Biology Interdisciplinary Working Group. Circulation 117: 2544-2565 [Abstract] [Full text]  
  • MacDonald, M. R., Petrie, M. C., Hawkins, N. M., Petrie, J. R., Fisher, M., McKelvie, R., Aguilar, D., Krum, H., McMurray, J. J.V. (2008). Diabetes, left ventricular systolic dysfunction, and chronic heart failure. Eur Heart J 29: 1224-1240 [Abstract] [Full text]  
  • Tuerk, P. W., Mueller, M., Egede, L. E. (2008). Estimating Physician Effects on Glycemic Control in the Treatment of Diabetes: Methods, effects sizes, and implications for treatment policy. Diabetes Care 31: 869-873 [Abstract] [Full text]  
  • Carrier, J. (2008). Aerobic plus resistance training was more effective than either alone for glycaemic control in type 2 diabetes. Evid. Based Nurs. 11: 48-48 [Full text]  
  • Fowler, M. J. (2008). Microvascular and Macrovascular Complications of Diabetes. Clin. Diabetes 26: 77-82 [Full text]  
  • Marwick, T H (2008). Diabetic heart disease. Postgrad. Med. J. 84: 188-192 [Abstract] [Full text]  
  • Heisler, M. (2008). Actively Engaging Patients in Treatment Decision Making and Monitoring as a Strategy to Improve Hypertension Outcomes in Diabetes Mellitus. Circulation 117: 1355-1357 [Full text]  
  • Naik, A. D., Kallen, M. A., Walder, A., Street, R. L. Jr (2008). Improving Hypertension Control in Diabetes Mellitus: The Effects of Collaborative and Proactive Health Communication. Circulation 117: 1361-1368 [Abstract] [Full text]  
  • Bakris, G. L., Berkwits, M. (2008). Trials That Matter: The Effect of a Fixed-Dose Combination of an Angiotensin-Converting Enzyme Inhibitor and a Diuretic on the Complications of Type 2 Diabetes. ANN INTERN MED 148: 400-401 [Full text]  
  • Kelly, C. J., Booth, G. (2008). Pharmacist-led structured care for patients with diabetic nephropathy. British Journal of Diabetes & Vascular Disease 8: 86-88 [Abstract]  
  • Scanlon, P H (2008). The English national screening programme for sight-threatening diabetic retinopathy. J Med Screen 15: 1-4 [Abstract] [Full text]  
  • Gaede, P., Lund-Andersen, H., Parving, H.-H., Pedersen, O. (2008). Effect of a Multifactorial Intervention on Mortality in Type 2 Diabetes. NEJM 358: 580-591 [Abstract] [Full text]  
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  • HORNICK, T., ARON, D. C. (2008). Preventing and managing diabetic complications in elderly patients. Cleveland Clinic Journal of Medicine 75: 153-158 [Abstract] [Full text]  
  • Takata, Y., Osawa, H., Kurata, M., Kurokawa, M., Yamauchi, J., Ochi, M., Nishida, W., Okura, T., Higaki, J., Makino, H. (2008). Hyperresistinemia Is Associated With Coexistence of Hypertension and Type 2 Diabetes. Hypertension 51: 534-539 [Abstract] [Full text]  
  • Osher, E., Stern, N. (2008). Diastolic Pressure in Type 2 Diabetes: Can target systolic pressure be reached without "diastolic hypotension"?. Diabetes Care 31: S249-S254 [Abstract] [Full text]  
  • Dixon, J. B., O'Brien, P. E., Playfair, J., Chapman, L., Schachter, L. M., Skinner, S., Proietto, J., Bailey, M., Anderson, M. (2008). Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes: A Randomized Controlled Trial. JAMA 299: 316-323 [Abstract] [Full text]  
  • Swaminathan, K., Davies, J., Struthers, A. (2008). Review: Aldosterone antagonism in type 2 diabetes mellitus -- a new therapeutic approach to diabetic macrovascular disease?. British Journal of Diabetes & Vascular Disease 8: 16-19 [Abstract]  
  • Mcgowan, N., Cockburn, A., Strachan, M. W., Padfield, P. L, Mcknight, J. A (2008). Initial and sustained cardiovascular risk reduction in a pharmacist-led diabetes cardiovascular risk clinic. British Journal of Diabetes & Vascular Disease 8: 34-38 [Abstract]  
  • Wolever, T. M., Gibbs, A. L, Mehling, C., Chiasson, J.-L., Connelly, P. W, Josse, R. G, Leiter, L. A, Maheux, P., Rabasa-Lhoret, R., Rodger, N W., Ryan, E. A (2008). The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein. Am. J. Clin. Nutr. 87: 114-125 [Abstract] [Full text]  
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Rapid Responses:

Read all Rapid Responses

diet & exercise control of diabetes
Michael Coulson
bmj.com, 25 Sep 1998 [Full text]
UKPDS -a model in ethics and diabetes public health
K M Venkat Narayan
bmj.com, 25 Sep 1998 [Full text]
Publishing important findings in two journals
Jonathan Richards
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