Cardiometabolic & kidneyMeta-analysis
Blood Pressure Levels and Outcomes in Type 2 Diabetes
- Systematic review and dose-response meta-analysis of cohort studies
- one-stage mixed-effects dose-response meta-analysis
PubMed, Embase and Web of Science searched from inception to November 30, 2024
Authors' conclusion
In type 2 diabetes, BP is linearly or monotonically associated with most cardiovascular and renal outcomes. Low SBP does not appear to be associated with an elevated risk of all-cause mortality compared with higher BP targets, suggesting that previously reported associations are likely due to reverse causation and unmeasured confounding.
Study context
- Population
- Participants with T2DM113 articles
- Participants
- 5,875,364 participants · 89 cohorts
- Comparison
- SBP and DBP levels across a wide range
- Outcome
- All-cause mortality, CV and renal outcomes across BP levels
Pooled result
As reported in the abstract
- J-shaped association of SBP with all-cause mortality
- J-shaped associations of SBP with CV events and DBP with all-cause mortality, with flattened risks at lower blood pressure (BP) levels
- Positive linear or monotonic trends for renal events, eGFR decline and development or progression of albuminuria
Further pooled results
Excluding studies with baseline CVD or cancer
- Significantly lower risk of CV events at lower SBP levels and flattened risk of all-cause mortality
Original publication
Blood Pressure Levels and Outcomes in Type 2 Diabetes. J Am Coll Cardiol. Published 21 January 2026. doi:10.1016/j.jacc.2025.10.068
Summarised from the published abstract; every number is checked against it