title: Safety and feasibility of achieving lower systolic blood pressure goals in persons with type 2 diabetes: the SANDS trial.
abstract: 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.
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD 21201, USA. mweir@medicine.umaryland.edu
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Weir
authors.forename: Fawn
authors.initials: F
authors.lastname: Yeh
authors.forename: Angela
authors.initials: A
authors.lastname: Silverman
authors.forename: Richard B
authors.initials: RB
authors.lastname: Devereux
authors.forename: James M
authors.initials: JM
authors.lastname: Galloway
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Henderson
authors.forename: William J
authors.initials: WJ
authors.lastname: Howard
authors.forename: Marie
authors.initials: M
authors.lastname: Russell
authors.forename: Charlton
authors.initials: C
authors.lastname: Wilson
authors.forename: Robert
authors.initials: R
authors.lastname: Ratner
authors.forename: John
authors.initials: J
authors.lastname: Sorkin
authors.forename: Jason G
authors.initials: JG
authors.lastname: Umans
authors.forename: Jerome L
authors.initials: JL
authors.lastname: Fleg
authors.forename: Mario
authors.initials: M
authors.lastname: Stylianou
authors.forename: Elisa
authors.initials: E
authors.lastname: Lee
authors.forename: Barbara V
authors.initials: BV
authors.lastname: Howard
mesh_terms: D000368:Aged; D000465:Algorithms; D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D008078:Cholesterol, LDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology*; D017706:Lisinopril / Q000009:adverse effects / Q000627:therapeutic use; D019808:Losartan / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D014481:United States
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D008078:Cholesterol, LDL; D017706:Lisinopril; D019808:Losartan