Experts said the findings add to the debate on when to initiate therapy, but questioned the authors' conclusions.
The study "contributes to the ongoing discussion about blood pressure targets and the importance of blood pressure control in people who have diabetes," said Dr. Ronald Tamler, clinical director of the Mount Sinai Diabetes Center in New York City.
"However, we should not forget that this latest study is merely a computer simulation. Studies have shown that uncontrolled blood pressure in real patients with diabetes is still a source of concern and may lead to complications, such as heart disease, stroke and kidney disease," added Tamler, who is also assistant professor of medicine at the center.
One cardiologist added that quick action in getting blood pressure under control can be life-saving, and he questioned whether waiting for lifestyle changes to occur was advisable.
Dr. Henry Black, clinical professor of cardiology at NYU Langone Medical Center in New York City, said that many studies have shown "that prompt control of blood pressure reduces events, although neither of these studies were specifically aimed at patients with diabetes, although many of the study volunteers had diabetes mellitus."
According to Black, most trials have found changes in lifestyle to be less effective than drug therapy in reining in high blood pressure. That means that, "dithering with 'lifestyle changes' . . . will delay getting effective treatment to these high-risk individuals," he said. "The time wasted focusing on control of diabetes with lifestyle changes is a bad bargain, if blood pressure is pushed to the back burner."
The U.S. National Heart, Lung, and Blood Institute has more
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