People with Type 2 diabetes often have high blood pressure, which can increase the risk of heart attacks, strokes, heart failure, and death from heart disease.
A major new study from China shows that lowering systolic blood pressure—the top number in a blood pressure reading—to below 120 mm Hg can greatly reduce those risks in people with diabetes.
The study was presented on November 16, 2024, at the American Heart Association’s Scientific Sessions in Chicago. It’s part of an ongoing effort to find better ways to manage heart health in people with Type 2 diabetes.
The study, called the BPROAD trial, followed more than 12,800 people with Type 2 diabetes across 145 clinics in mainland China. All participants had high systolic blood pressure and were at risk of heart disease.
The goal was to compare two groups: one group received standard care to lower blood pressure below 140 mm Hg, and the other group received more intensive care to lower blood pressure below 120 mm Hg.
After four years, people in the intensive treatment group had an average systolic blood pressure of 120.6 mm Hg, while those in the standard group averaged 132.1 mm Hg.
The results showed that the intensive group had a 21% lower risk of major cardiovascular problems. These included non-fatal strokes, non-fatal heart attacks, heart failure, and deaths caused by heart disease.
In real numbers, 393 people (or about 1.65% each year) in the intensive group experienced a major heart problem, compared to 492 people (or 2.09% each year) in the standard group. This means the intensive treatment helped prevent many serious health issues.
However, lowering blood pressure too much can have side effects. In the intensive group, more people experienced low blood pressure with symptoms (like dizziness or fainting) and high potassium levels in the blood, which can be dangerous. But overall, serious side effects were similar in both groups.
This study matters because most people with Type 2 diabetes also have high blood pressure—almost 75% according to U.S. health data. When both conditions are not managed properly, they can damage blood vessels, kidneys, and the heart. That’s why doctors recommend healthy lifestyle changes and medication.
The study’s lead author, Dr. Guang Ning from Shanghai Jiao Tong University, said these results support aiming for a lower blood pressure target in people with Type 2 diabetes to reduce the risk of heart disease. He hopes future guidelines will reflect these findings.
The average participant was 64 years old, with about equal numbers of men and women. The people in both groups were similar at the beginning of the study in terms of blood pressure, weight, blood sugar, kidney function, and other health factors. The study ran from early 2019 to the end of 2021, with follow-up lasting up to five years.
One important point is that this study only included people from China. While the results are important, they may not apply the same way to people in other countries or with different backgrounds.
Also, patients and doctors knew which treatment group they were in, and some participants reported blood pressure levels from home during COVID-19 lockdowns.
Still, this is one of the largest studies to show that lowering systolic blood pressure to under 120 mm Hg can save lives in people with Type 2 diabetes. It builds on previous research that found similar benefits in people with high blood pressure but without diabetes.
In conclusion, carefully lowering blood pressure may offer strong protection against heart disease for people with diabetes. Doctors and patients should weigh the benefits and risks of intensive treatment and talk about the best strategy for each person’s needs.
If you care about blood sugar, please read studies about why blood sugar is high in the morning, and how to cook sweet potatoes without increasing blood sugar.
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