INVEST study和ACCORD差不多--DM有CAD的人，血壓控太嚴也沒用，SBP < 140可也

Tight BP Control Does Not Improve Cardiovascular Outcomes in Diabetics with Coronary Artery Disease


Tight blood pressure control is no better than standard control in patients with diabetes and coronary artery disease, according to a post hoc analysis from the INVEST study published in JAMA.


Researchers examined data on some 6400 adults with diabetes and CAD who had been randomized to a calcium-antagonist–based or beta-blocker–based antihypertensive regimen. During some 17,000 patient-years of follow-up, risk for the primary outcome — a composite of all-cause mortality, myocardial infarction, and stroke — did not differ between patients who achieved tight BP control (systolic BP, <130 mm Hg) and those who achieved standard control (130–139 mm Hg). During an extended follow-up, tight-control patients appeared to have increased mortality.


The authors conclude that "there is no compelling evidence" to support lowering systolic BP below 130 mm Hg in this patient population.

https://docs.google.com/fileview?id=0B278nGJMQBk7ZmJhYzgwYjYtY2I2YS00NTBjLTlhOTAtMDdkOTNjZDFiNTFk&hl=zh_TW

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