Blood pressure lowering and risk of new-onset T2D: an individual participant data meta-analysis
Lowering Blood pressure is a known strategy for preventing microvascular and macrovascular complications of diabetes. Still, its role in the prevention of diabetes itself is unclear. Hence, Milad Nazarzadeh and colleagues have conducted research under the title “Blood pressure lowering and risk of new-onset type 2 diabetes: an individual participant data meta-analysis” published in The Lancet Journal. The summary of this study is given below:
Objective:
To investigate the relationship between lowering blood pressure and risk of new-onset type 2 diabetes.
Method:
Data were collected from 22 studies conducted between 1973 and 2008 by the Blood Pressure Lowering Treatment Trialists’ Collaboration (Oxford University, Oxford, UK). A one-stage individual participant data meta-analysis was performed, here data were pooled to investigate the effect of blood pressure-lowering per se on the risk of new-onset type 2 diabetes. An individual participant data network meta-analysis was used to examine the differential effects of five major classes of antihypertensive drugs on the risk of new-onset type 2 diabetes. All primary and secondary prevention trials that used a specific class or classes of antihypertensive drugs versus placebo were included. For the one-stage individual participant data meta-analysis, a stratified Cox proportional hazards model was used whereas for the individual participant data network meta-analysis, logistic regression models were used to calculate the relative risk (RR) for drug class comparisons.
Findings:
The evidence suggests that reduction in blood pressure can be an effective measure to lower the risk of type 2 diabetes. This evidence also supports the indication for selected classes of antihypertensive drugs for the prevention of type 2 diabetes, which could further refine the selection of drug choice according to an individual’s risk profile. In particular, ACEIs and ARBs should be considered as having the most favorable outcomes when the clinical risk of diabetes is a concern.
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