High blood pressure is associated with a significantly increased risk of early death and low blood pressure is also a risk factor. But at which blood pressure values is the risk of early death the lowest?
A research team led by Professor Tazeen H. Jafar from Duke-NUS Medical School in Singapore examined the connection between blood pressure levels and cardiovascular mortality risk in people with type 2 diabetes and published the results in the “Journal of the American Heart Association”. .
High blood pressure increases the risk of death
High blood pressure is associated with an increased risk of cardiovascular mortality (death from cardiovascular diseases) and high blood pressure (hypertension) is one of the most important modifiable risk factors for mortality, according to the Robert Koch Institute (RKI).
The limit values for hypertension are defined as 140 mmHg for systolic blood pressure and 90 mmHg for diastolic blood pressure. However, it remains unclear at what values the risk of early death is actually lowest.
Especially since, according to the research team, it is also suspected that intensive blood pressure reduction could paradoxically increase the risk of cardiovascular disease, especially in people with type 2 diabetes.
Using data from 83,721 people with type 2 diabetes from the multi-institutional diabetes registry in Singapore, the team has now examined how blood pressure levels are associated with the risk of early death due to cardiovascular disease for the period 2013 to 2019.
These blood pressure values are optimal
The data analysis showed that the lowest risk of cardiovascular death occurred with a systolic blood pressure of 120 to 129 mmHg. Once the systolic value reached 130 mmHg or more, the risk increased sharply, the team reports.
In terms of diastolic pressure, the lowest risk occurred at blood pressure values of 80 to 89 mmHg, and values above 90 mmHg increased the risk of death in adults over the age of 65, the researchers continued. A diastolic blood pressure below 70 mmHg also increased the risk of cardiovascular mortality.
“A diastolic pressure below 70 mmHg could therefore be potentially harmful in patients with diabetes, although it is unclear whether this association was directly causal,” explains Professor Jafar.
Adapt clinical guidelines
The results support clinical guidelines that recommend systolic target values below 130 mmHg in people with diabetes to protect against heart disease and stroke, but at the same time the risks should be carefully considered if diastolic pressure becomes too low (below 70 mmHg), they emphasize researchers.
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“Given the worrying deterioration in blood pressure levels worldwide, including in the US and here in Singapore, this study is an urgent reminder of the need for more effective blood pressure control in diabetes,” concludes Professor Jafar.
The aim must be to reduce the increased systolic pressure to values between 120 and 129 mmHg through lifestyle adjustments and medication, while at the same time keeping an eye on the diastolic values and general health. (fp)
