title: [The efficacy of antihypertensive treatment on diabetes mellitus or impaired glucose tolerance patients with blood pressure below 140/90 mm Hg: a meta-analysis].
abstract: OBJECTIVE
  To investigate whether antihypertensive treatment is beneficial to patients with diabetes mellitus when their blood pressure (BP) is below 140/90 mm Hg (1 mm Hg = 0.133 kPa).
  
  
  METHODS
  MEDLINE, EMBASE, IPA database and secondary resources were searched with terms including blood pressure, hypertension and anti-hypertension drug.
  
  
  METHODS
  random control study; subjects were patients with diabetes mellitus or impaired glucose tolerance; endpoint BP ≤ 140/90 mm Hg; endpoint BP between two groups had significant differences. There were 16 studies meet inclusive criteria with a total of 51 470 patients. RR and 95%CI were used as index to judge the difference of clinical outcomes between aggressive antihypertensive treatment group and standard antihypertensive treatment group. RevMan5.0 software was used for statistical analysis.
  
  
  RESULTS
  When BP of patients with diabetes mellitus were below 140/90 mm Hg, anti-hypertensive treatment could reduce incidence rate of cardiovascular event (RR 0.91, 95%CI 0.87 - 0.96, P = 0.0004) and stroke (RR 0.75, 95%CI 0.63 - 0.88, P = 0.0005), and increased incidence rate of symptomatic hypotension (RR 3.57, 95%CI 1.41 - 11.20, P = 0.03) and hyperpotassemia (RR 1.57, 95%CI 1.05 - 2.33, P = 0.03). There were no significant differences in all-cause mortality (RR 0.94, 95%CI 0.87 - 1.01, P = 0.08), cardiovascular mortality (RR 0.95, 95%CI 0.85 - 1.08, P = 0.05), myocardial infarction (RR 0.93, 95%CI 0.82 - 1.05, P = 0.26), heart failure (RR 0.90, 95%CI 0.76 - 1.06, P = 0.21) between the aggressive antihypertensive treatment group and standard antihypertensive treatment group.
  
  
  CONCLUSIONS
  When blood pressure of patients with diabetes mellitus was below 140 mm Hg, there was little benefit from aggressive antihypertensive treatment, and the risk of serious adverse events even increased.
authors.affiliation: Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China.
authors.forename: Xue
authors.initials: X
authors.lastname: Geng
authors.forename: Wei
authors.initials: W
authors.lastname: Cui
authors.forename: Xiao-hong
authors.initials: XH
authors.lastname: Yang
authors.forename: Rui-qin
authors.initials: RQ
authors.lastname: Xie
authors.forename: Ji-dong
authors.initials: JD
authors.lastname: Zhang
authors.forename: Hong-mei
authors.initials: HM
authors.lastname: Zheng
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005260:Female; D018149:Glucose Intolerance; D044882:Glucose Metabolism Disorders / Q000503:physiopathology*; D006801:Humans; D008297:Male; D016032:Randomized Controlled Trials as Topic
chemical_list: D000959:Antihypertensive Agents