Intensive vs. Standard Systolic Blood Pressure Control in Type 2 Diabetes: A Retrospective Study

Tooba Adil; Zafar Ahmad Khan; Misbah Farooq Awan; Ghazala Masood Farrukh; Nuzhat Firdous; Shazia Nazar

doi:10.70749/ijbr.v3i1.460

Authors

Tooba Adil Community Medicine, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan. https://orcid.org/0009-0001-5707-1702
Zafar Ahmad Khan Department of Medicine, Bolan Medical College, Quetta, Balochistan, Pakistan.
Misbah Farooq Awan Combined Military Hospital (CMH), AJK, Muzaffarabad, Pakistan.
Ghazala Masood Farrukh Department of Physiology, Dow Medical College, Dow University of Health Sciences, Karachi, Sindh, Pakistan.
Nuzhat Firdous Principal, Ziauddin Faculty of Nursing and Midwifery (ZUFONAM), Sukkur Campus, Sindh, Pakistan.
Shazia Nazar Department of Physiology, Dow Medical College, Dow University of Health Sciences, Karachi, Sindh, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i1.460

Keywords:

Type 2 Diabetes, Systolic Blood Pressure Control, Cardiovascular Events, Hyperkalemia, Hypotension, Mortality, Intensive Treatment, Standard Treatment, Diabetes Management, Cox Regression

Abstract

Background: Systolic blood pressure (SBP) control is a critical aspect of managing Type 2 diabetes, which is associated with an increased risk of cardiovascular events. This retrospective study compares the effects of intensive SBP control (targeting < 120 mmHg) versus standard SBP control (targeting < 140 mmHg) on cardiovascular outcomes, mortality, and adverse effects in Type 2 diabetes patients. Methods: A total of 500 patients with Type 2 diabetes were included, with 250 in the intensive control group and 250 in the standard control group. Cardiovascular outcomes (heart attacks, strokes, cardiovascular mortality), adverse effects (hypotension, hyperkalemia), and medication adherence were assessed. Cox proportional hazards regression was performed to evaluate the effect of intensive SBP control on cardiovascular risk. Results: The intensive control group showed a significantly lower incidence of heart attacks (4.8% vs. 7.2%, p=0.03), strokes (3.2% vs. 5.6%, p=0.02), and cardiovascular mortality (2.4% vs. 4.8%, p=0.04) compared to the standard control group. However, the intensive group had a higher incidence of hyperkalemia (3.6% vs. 1.2%, p=0.04) and symptomatic hypotension (5.6% vs. 3.2%, p=0.09). Cox regression analysis revealed a 21% reduced risk of major cardiovascular events in the intensive control group (HR = 0.79, 95% CI: 0.62-0.99, p=0.04). Conclusion: Intensive SBP control significantly reduces cardiovascular events and mortality in patients with Type 2 diabetes. However, the increased risk of hyperkalemia and hypotension suggests that careful monitoring and individualized treatment strategies are essential. Further prospective trials are needed to confirm these findings and refine management guidelines for patients with Type 2 diabetes.

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