Safety and feasibility of achieving lower systolic blood pressure goals in persons with type 2 diabetes: the SANDS trial.
The Stop Atherosclerosis in Native Diabetics Study (SANDS) was a randomized open-label clinical trial in type 2 diabetics designed to examine the effects of intensive reduction of blood pressure, aggressive vs standard goals (< or =115/75 mm Hg vs < or =130/80 mm Hg), and low-density lipoprotein (LDL) cholesterol on the composite outcome of change in carotid intimal-medial thickness and cardiovascular events. The study demonstrated that in conjunction with a lower LDL cholesterol target of 70 mg/dL, aggressive systolic blood pressure-lowering resulted in a reduction in carotid intimal-medial thickness and left ventricular mass without measurable differences in cardiovascular events. The blood pressure treatment algorithm included renin-angiotensin system blockade, with other agents added if necessary. The authors conclude that both standard and more aggressive systolic blood pressure reduction can be achieved with excellent safety and good tolerability in patients with type 2 diabetes mellitus.
Weir
Matthew R
MR
University of Maryland School of Medicine, Baltimore, MD 21201, USA. mweir@medicine.umaryland.edu
Yeh
Fawn
F
Silverman
Angela
A
Devereux
Richard B
RB
Galloway
James M
JM
Henderson
Jeffrey A
JA
Howard
William J
WJ
Russell
Marie
M
Wilson
Charlton
C
Ratner
Robert
R
Sorkin
John
J
Umans
Jason G
JG
Fleg
Jerome L
JL
Stylianou
Mario
M
Lee
Elisa
E
Howard
Barbara V
BV
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D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D008078:Cholesterol, LDL; D017706:Lisinopril; D019808:Losartan