Tight Glucose Control Doesn't Prevent Strokes Long Term
(HealthDay News) — A six-year study of people with type 2 diabetes shows that intensively lowering blood pressure has a long-lasting effect in preventing heart attacks, strokes, and deaths, but intensive blood glucose control does not. The findings were published online September 19 in the New England Journal of Medicine to coincide with presentation of the findings at the annual meeting of the European Association for the Study of Diabetes in Vienna.
Bruce Neal, MD, PhD, a professor of medicine at the University of Sydney, and colleagues followed nearly 8,500 participants of a completed diabetes trial. Some participants had had their blood pressure and blood glucose levels strictly controlled, while others had received standard care.
The original study – ADVANCE – "showed clearly that you got these great benefits from blood pressure reduction and you also got some benefit from blood sugar lowering," Neal told HealthDay. The unanswered question, Neal said, was if intensive blood pressure and blood glucose control were stopped, would the benefits go away or last. To find out, they stopped the intensive treatment, but continued to follow the trial participants for an additional 5.9 years. The researchers found no evidence that intensive glucose control led to reduction in mortality or macrovascular events.
Among patients who had their blood pressure reduced in the original trial to 135/75mmHg, the benefit in reducing the risk of dying from a heart attack or stroke remained, although to a lesser degree, as time went by. "The implication is to continue to take blood pressure drugs if you want to get maximum protection," Neal said.