Influence of pre-treatment blood pressure levels on antihypertensive drug benefits in diabetics: the roadmap experience

Purpose: Most guidelines for treatment of hypertension in the setting of diabetes recommend a blood pressure (BP) target of Material: Substudy with blood pressure readings. Methods: The response after initiation of therapy and adequacy of BP control across patients with different BP levels at baseline were analysed. Results: BP at randomisation was 136.2(15.3)/80.6(9.5) [mean (SD)] mmHg with a range of 87–213/37–123 mmHg. At 1 year, mean BP was 127 (11.9)/75 (8.1) mmHg and the overall control rate (160/100 from 9 to 2%[[mean BP change −31 (15.7)/ −14 (9.8) mmHg]] and of 140–159/90–99 mmHg from 32 to 11% [[mean BP change −16(12.7)/ −8.9 (8.7) mmHg]], with corresponding increases in the prevalence of patients with baseline BP levels of 120–139/80–99 from 48 to 65% [[mean BP change −4.1 (10.6)/ −3.1 (7.8) mmHg]]and of Conclusion: Blood pressure control is feasible in patients with diabetes without nephropathy, independent of baseline BP values. Asymmetric BP-lowering in the first year after starting therapy represents a true antihypertensive effect with sustainable shifts in BP severity.