Stricter blood pressure control appears to protect adults with type 2 diabetes from major cardiovascular events, according to a study presented at the American Heart Association's Scientific Sessions 2024 in Chicago.

In the trial of nearly 13,000 adults with type 2 diabetes and hypertension, keeping systolic blood pressure to 120 mm Hg or lower led to a reduced risk of heart attack, stroke, heart failure and cardiovascular-related death compared to the standard approach of keeping it below 140 mm Hg.

Four years after the start of the study, average systolic pressures were 120.6 mm Hg in the intensive treatment group and 132.1 mm Hg in the standard treatment group.

The combined rate of non-fatal stroke, non-fatal heart attack, hospitalization or treatment for heart failure, and heart-related deaths was 1.65% per year in the intensive treatment group and 2.09% per year in the standard treatment group.

The average patient age at enrollment was 64. After accounting for patients’ risk factors, the intensive treatment group had a 21% lower risk of major cardiovascular events, according to a report published in The New England Journal of Medicine.

Most participants in the intensive treatment group were initially given a two- or three-drug regimen of diuretics and other types of blood pressure-lowering medicines. Drug doses were increased or additional medications added at monthly intervals until systolic pressure was below 120 mm Hg.

The intensive treatment group had more non-serious symptoms related to low blood pressure, however.

Among the study's weaknesses is that participants sometimes used home blood pressure monitoring to self-report their blood pressure levels via telephone. The researchers also noted that results of this Chinese study may not be generalizable to people of other ethnic populations.

Still, the findings “provide strong support for a more intensive systolic blood pressure target in people with type 2 diabetes to prevent major cardiovascular events,” an investigative lead said.