Blood pressure control goals for diabetic patients!

  In ordinary patients with simple hypertension, blood pressure needs to be controlled to no more than 140/90mmHg.  Simple systolic hypertension (SBP>140mmHg and diastolic blood pressure [DBP] <90mmHg): SBP control of 140-150mmHg and DBP>60mmHg is recommended. for patients with DBP≤60mmHg, SBP control of 160mmHg may be more appropriate.  The latest hypertension guideline study points out that the combination of diabetes combined with hypertension increases the serious harm and other comprehensive factors, in order to fully reduce the risk of complications, the blood pressure control for diabetic patients is more stringent than non-diabetic population, generally requiring control below 130/80mmHg, if the patient is also combined with diabetic nephropathy (24-hour urine protein > 1g), blood pressure control requirements are more stringent, should be below 120/75mmHg, so as to effectively protect the kidney function.  Of course, this is not absolute, for patients with diabetes mellitus combined with hypertension who are over 65 years old or with severe coronary artery disease, the blood pressure control target can be relaxed appropriately, not to exceed 140/90mmHg is fine, if the blood pressure is lowered too low but easy to cause more adverse events, including ischemic stroke, postural hypotension and so on.  In conclusion, for patients with diabetes combined with hypertension, blood pressure control is as important as blood glucose control. Moreover, blood pressure control goals should be individualized. In principle, the higher the patient’s risk of cardiovascular disease, the more stringent the blood pressure control should be. However, blood pressure control goals can be relaxed in patients of advanced age and severe coronary artery disease, and care should also be taken to avoid the occurrence of insufficient blood supply caused by too low blood pressure control. Geriatric syndromes including cognitive impairment, hearing and vision loss, depression, and chronic pain should also be taken into account when making blood pressure control goals.