The National Prescribing Centre has published MeReC Extra 45 (PDF) which contains information regarding recent study results that identified blood pressure variability as an independent risk factor for stroke and the relationship between blood glucose lowering and mortality in type 2 diabetes.
The first section discusses the results of a recent study published in the Lancet that identified variability in systolic blood pressure as an independent risk factor for stroke even after correction for mean systolic blood pressure. Additional studies have identified that some antihypertensive classes may offer advantages however there are limitations in the analyses and it is therefore recommended that clinicians continue to follow current guidelines until they can be formally reviewed.
The second section discusses the results of another study published in the Lancet that reviewed the association between HbA1c and all-cause mortality in patients with type 2 diabetes. This study found that the lowest risk of mortality was associated with an HbA1c of 7.5% (59mmol/mol). These findings are consistent with the results of several randomised controlled studies. Clinicians should take these findings into consideration when thinking about intensifying hypoglycaemic treatment.
Action: Clinicians who see patients with hypertension or type 2 diabetes will find this information useful and informative.