To assess the association of intensive blood pressure control with major adverse cardiovascular events (MACE) and adverse events compared with conventional control in patients with type 2 diabetes (T2D).
Approach:
Key Findings:
Intensive blood pressure control reduced the risk of MACE (7.9% vs 9.7%; RR, 0.80; 95% CI, 0.73–0.89; P < 0.001).
Significant reduction in stroke risk with intensive treatment (RR, 0.73; 95% CI, 0.60–0.87; P = 0.008).
No significant differences in heart failure, myocardial infarction, or cardiovascular death risk.
Intensive treatment showed a borderline increased risk of hypotension (RR, 4.61; 95% CI, 1.01–20.99; P = 0.05).
Interpretation:
Limitations:
Limited evidence on adverse events other than hypotension.
Variability in blood pressure targets and treatment strategies across included trials.
In a target-trial emulation of more than 600,000 veterans, GLP-1 RA initiators saw fewer new substance use disorders—and patients with existing SUDs had fewer overdoses, hospitalizations, and deaths.
