A new study from Cedars-Sinai’s Smidt Heart Institute has found that women with type 2 diabetes who were diagnosed with high blood pressure before age 50 may benefit from more aggressive treatment to lower their blood pressure.
The study shows that this approach can reduce their risk of serious heart problems like heart attacks and strokes. The findings were published in the medical journal Diabetes Care.
Researchers have long known that women with type 2 diabetes face a higher risk of developing heart disease than men with the same condition. They also know that women’s blood pressure tends to rise more quickly than men’s as they age.
With this in mind, the research team wanted to see whether treating blood pressure more intensively could help a certain group of women—those diagnosed with high blood pressure at a younger age.
Blood pressure is measured using two numbers. The top number (called systolic) shows how much pressure your blood is putting on your arteries when your heart beats. The bottom number (diastolic) shows the pressure between heartbeats.
If your blood pressure is too high for too long, it can damage your blood vessels and increase the risk of heart attacks, strokes, and other serious problems.
Doctors generally use two approaches to treat high blood pressure. The standard approach aims to keep the top number under 140. Intensive treatment, however, sets a lower goal—keeping systolic blood pressure below 120. Reaching this lower number usually requires more or higher doses of medication.
To explore how well intensive treatment works for different people, the researchers looked at data from a large study called ACCORD (Action to Control Cardiovascular Risk in Diabetes). This study included 4,733 people with type 2 diabetes who were randomly assigned to either standard or intensive blood pressure treatment.
The Cedars-Sinai team focused on 3,792 participants who also reported how old they were when they were diagnosed with high blood pressure.
They discovered something striking: women with type 2 diabetes who had been diagnosed with high blood pressure before age 50 and who received intensive treatment had significantly fewer heart problems over 4.5 years compared to those who received standard treatment.
These women were less likely to have heart attacks, strokes, or other cardiovascular events. However, the same benefit was not seen in women who developed high blood pressure at age 50 or older—or in men, regardless of age.
This suggests that the timing of high blood pressure diagnosis, as well as gender, matters when deciding how aggressively to treat it. Dr. Susan Cheng, one of the study’s lead authors, explained that these findings highlight the importance of tailoring treatments based on individual differences—especially between men and women, and depending on when a health problem starts.
Dr. Joseph Ebinger, another author of the study, said this may be the first research to clearly show that intensive blood pressure treatment could be a better option for younger women with type 2 diabetes. He added that the results support the idea that treating high blood pressure early, and not waiting, can prevent many health problems down the road.
Although these results are promising, the researchers say more studies are needed to confirm their findings. Still, this research could help doctors make better treatment decisions and encourage earlier action for women at higher risk.
In summary, this study shows that for women with type 2 diabetes who were diagnosed with high blood pressure before age 50, lowering blood pressure more intensively may offer strong protection against heart disease. It’s a reminder that early and personalized treatment can make a big difference in long-term health.
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The research findings can be found in Diabetes Care.
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