Strict Diabetes Management Doesn’t Prevent Macrovascular Events

(HealthDay News) — A study of people with type 2 diabetes published online in the New England Journal of Medicine showed that the intensive lowering of blood pressure has a long-lasting effect in the prevention of heart attacks, strokes and death, but intensive blood glucose control does not. 

Bruce Neal, MD, PhD, a professor of medicine at the University of Sydney, and colleagues presented the findings at the annual meeting of the European Association for the Study of Diabetes in Vienna. The team followed nearly 8,500 participants of a completed diabetes trial, some of which had had their blood pressure and blood glucose levels strictly controlled, while others had received standard care.

The original study “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 135/75 mm Hg, the benefit in reducing the risk of mortality from a heart attack or stroke remained, although to a lesser degree, as time went by.”No clear protective or harmful effects of intensive glucose control with respect to death from any cause or major macrovascular events were identified,” the study authors wrote. “The implication is to continue to take blood pressure drugs if you want to get maximum protection,” Neal said. 


  1. Zoungas S et al. N Engl J Med. 2014;doi;10.1056/NEJMoa1407963.