Screening Adults for Type 2 Diabetes: A Review of the Evidence

You Are Here: AHRQ Home > Clinical Information > U.S. Preventive Services Task Force (USPSTF) > Guide to Clinical Preventive Services, 2001-2004 > Screening: Type 2 Diabetes > Review of the Evidence

Table 2. Studies of Intensity of Treatment with Antihypertensive Medications

Study, Year (Population) (Quality)	Study Length Age (y)	N Groups (Patients)	Blood Pressure Control (mm Hg)	Myocardial Infarction	Stroke	Death from CVD Events	Non-CVD Outcomes		Adherence Withdrawal	Blinding Comments
UKPDS-38, 1998 (60) (patients with diabetes and hypertension) (fair)	8.4 56-57	Less tight blood pressure control: 390	154/87	23.5¹	11.6¹	DM mortality 20.3¹ 13.7 (p=0.019)	ESRD 2.3¹ 1.4 (p=0.29)	Vision 19.4%⁴ 10.2%⁴ (p=0.004)	No drug 43% p-y²	Open label; blinded outcome assessment
	8.4 56-57	Tight: 758	144/82	18.6 (p=0.13)	6.5 (p=0.013)	DM mortality 20.3¹ 13.7 (p=0.019)	ESRD 2.3¹ 1.4 (p=0.29)	Vision 19.4%⁴ 10.2%⁴ (p=0.004)	No drug 6% p-y² 4% study withdrawal	Open label; blinded outcome assessment
HOT, 1998 (59) Diabetes Subgroup (fair)	3.8 61.5	Target DBP ≤90³: 501	143.7/85.2	7.5¹	9.1¹	CVD mortality¹ 11.1¹ 11.2 3.7 (p=0.016)	NR		% DBP >90 mmHg 12% 7% 6% 2.6% study withdrawal	Open label; blinded outcome assessment
		≤85: 501	141.4/83.2	4.3	7.0
		≥80: 499	139.7/81.1	3.7 (p=0.11)	6.4 (p=0.34)
ABCD, 2000 (61) (patients with hypertension and diabetes) (fair)	5 57	Moderate blood pressure control: 233	138/86	No difference	No difference	All-cause mortality 10.7% 5.5% (p=0.037)	No difference in vision, ESRD, neuropathy		Participants on study drug ~70% of time.	Open label; blinded outcome assessment
	5 57	Intensive: 237	132/78	No difference	No difference	All-cause mortality 10.7% 5.5% (p=0.037)	No difference in vision, ESRD, neuropathy		Participants on study drug ~70% of time.	Open label; blinded outcome assessment
ABCD, 2002 (62) (normotensive patients with diabetes) (fair)	5.35 58-59	Moderate blood pressure control: 243	137/81	6.2%	5.4%	All-cause mortality 8.2% 7.6% (p=0.80)	Creatinine Clearance No difference	Vision NR	Participants on study drug ~70% of time.	Open label; blinded outcome assessment
	5.35 58-59	Intensive: 237	128/75	8.0% (p=0.43)	1.7% (p=0.03)	All-cause mortality 8.2% 7.6% (p=0.80)	Creatinine Clearance No difference	Vision NR	Participants on study drug ~70% of time.	Open label; blinded outcome assessment

¹ Per 1000 patient - years
² p - y = person - years
³ Target diastolic blood pressure (mm Hg)
⁴ Percentage with marked deterioration in vision

Notes: NR = not reported, BP = blood pressure, MI = myocardial infarction, CVD = cardiovascular disease, DBP = diastolic blood pressure, DM = diabetes mellitus, ABCD = Appropriate Blood Pressure Control in Diabetes, HOT = Hypertension Optimal Treatment, UKPDS = UK Prospective Diabetes Study.

Return to Document