糖尿病和糖尿病前期患者的降压治疗目标

Optimal blood pressure level among diabetes or prediabetes patients

大量临床证据表明在糖尿病合并高血压患者中降低血压能改善心脑血管疾病(CVD)结局,但是最优的降压治疗目标仍难以确定,并于近年成为学术争论的焦点。本文回顾了降压治疗的观察性和随机对照临床研究及近年来对糖尿病患者降压治疗目标的争论,结合我们在中国成年人群中不同糖代谢和血压状态对10年后CVD发病风险的研究,着重分析了在糖尿病和糖尿病前期患者中,在开展降压治疗的随机对照临床试验研究中需要特别关注的方面。

Accumulated evidences suggest that reduction in blood pressure may reduce cardiovascular morbidity and mortality in diabetes patients. However, the optimal blood pressure level to which blood pressure should be reduced in diabetes patients have not reached an agreement and significant controversy has surrounded this topic in these years. After reviewing the data from observational studies and clinical trials, we compared the similarities and differences of recommendations about blood pressure target for people with diabetes and hypertension. Based on our study about the 10 years effects of different blood pressure levels on cardiovascular disease events among Chinese adults with different glucose metabolism, we analyzed the critical factors on conducting randomized controlled trials concerning optimal blood pressure level among patients with diabetes or prediabetes.