- Question
- Does an intensive systolic blood-pressure target (<120 mm Hg) reduce major cardiovascular events compared with a standard target (<140 mm Hg) in patients with type 2 diabetes?
- Design
- Randomized, multicenter, parallel-group, open-label (single-masked) trial enrolling 12821 patients at 145 sites across China, with a median follow-up of 4.2 years.
- Population
- Patients aged 50 years or older with type 2 diabetes, elevated systolic blood pressure and increased cardiovascular risk. Mean age was 63.8 years and 45.3% were women.
- Intervention
- Intensive treatment targeting a systolic blood pressure <120 mm Hg, for up to 5 years.
- Control
- Standard treatment targeting a systolic blood pressure <140 mm Hg.
- Primary outcome
- Composite of nonfatal stroke, nonfatal myocardial infarction, treatment or hospitalization for heart failure, or death from cardiovascular causes.
- Results
- At 1 year, mean systolic blood pressure was 121.6 mm Hg in the intensive group and 133.2 mm Hg in the standard group. The primary outcome occurred in 393 patients (1.65 events per 100 person-years) with intensive treatment and 492 (2.09 per 100 person-years) with standard treatment (HR 0.79; 95% CI 0.69 to 0.90; P<0.001).
- Safety
- Serious adverse events were similar between groups, but symptomatic hypotension and hyperkalemia were more frequent with intensive treatment.
- Conclusion
- In patients with type 2 diabetes, targeting a systolic blood pressure <120 mm Hg significantly reduced major cardiovascular events compared with a <140 mm Hg target.
- Why it matters
- It provides direct evidence supporting tighter blood-pressure targets in people with type 2 diabetes at high cardiovascular risk, while requiring monitoring for hypotension and hyperkalemia.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 14, 2026