Researchers at the Smidt Heart Institute at Cedars-Sinai have found that women with type 2 diabetes who are diagnosed with hypertension before the age of 50 may experience significant health benefits from intensive blood pressure treatment.
The study, published in Diabetes Care, revealed that such treatment reduces the risk of developing cardiovascular disease in this group. However, these benefits were not observed in women diagnosed with hypertension after age 50 or in men.
Type 2 diabetes is a condition where the body struggles to control blood sugar levels, leading to various health complications, including a higher risk of cardiovascular disease.
Hypertension, or high blood pressure, is another condition that strains the heart and arteries, increasing the risk of heart attacks, strokes, and other cardiovascular problems. When both conditions occur together, as they often do, the risks are compounded.
Dr. Susan Cheng, one of the study’s senior researchers, noted that women with type 2 diabetes face greater cardiovascular risks than men with the same condition.
She explained that women’s blood pressure tends to rise faster than men’s as they age, which could contribute to their increased vulnerability. “Given these differences, we wanted to determine if certain women could benefit from more aggressive blood pressure management,” Cheng said.
Blood pressure is measured with two numbers. The top number, or systolic pressure, measures the force of blood against artery walls when the heart beats. The bottom number, or diastolic pressure, measures the pressure between heartbeats. A systolic reading below 120 mmHg is considered the target for intensive treatment, while standard treatment aims for a reading under 140 mmHg.
Intensive treatment typically involves using higher doses or more combinations of blood pressure-lowering medications to achieve the lower target. While this approach can be effective, it also requires careful management to avoid side effects or complications from medication.
To explore the effects of intensive blood pressure management, researchers analyzed data from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial.
This study involved 4,733 people with type 2 diabetes, with 3,792 participants providing details about the age at which they were diagnosed with hypertension. Over 4.5 years, researchers compared the outcomes of participants receiving intensive versus standard blood pressure treatment.
The results showed that women with type 2 diabetes who were diagnosed with hypertension before age 50 and treated intensively had fewer strokes, heart attacks, and other cardiovascular events compared to those receiving standard treatment.
This benefit was not observed in women diagnosed with hypertension later in life or in men, regardless of the age of hypertension onset.
Dr. Christine M. Albert, chair of the Department of Cardiology at the Smidt Heart Institute, highlighted the importance of tailoring treatments based on individual factors, such as gender and the timing of hypertension diagnosis.
“These findings remind us to consider differences between men and women, as well as the timing of health conditions, when making treatment decisions,” she said.
The study’s authors emphasized the need for more research to confirm these findings. Dr. Joseph Ebinger, one of the study’s contributors, noted that the results align with the idea that treating hypertension early can prevent serious health issues later in life.
“This may be the first study to suggest that intensive blood pressure treatment is a preferred approach for women with type 2 diabetes and early-onset hypertension,” he added.
While more studies are needed to validate the findings, this research offers valuable insights for healthcare providers. It highlights the importance of identifying women with type 2 diabetes and early-onset hypertension who could benefit from a more aggressive approach to managing their blood pressure.
By addressing these conditions earlier and more intensively, doctors may help reduce the long-term burden of cardiovascular disease in this high-risk group.
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The research findings can be found in Diabetes Care.
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