Standards of Medical Care in Diabetes - 2012

The 2012 Standards of Medical Care in Diabetes from the American Diabetes Association (ADA) contain recommendations on preventing and managing diabetes complications, including cardiovascular complications.

The ADA recommendations for hypertension and blood pressure control are summarized below.

Screening and Diagnosis



Commentary by Colleen Flynn MD

The ADA guidelines for blood pressure control in patients with diabetes are based on JNC 7, which was published in 2004. Fortunately, JNC 8 should be coming out in the fall of 2012.

The blood pressure goals in JNC 8 may be different than JNC 7, in that the goal blood pressure may be less than 140/90 in patients with diabetes. This is based on the ACCORD trial and the ADVANCE trial, which are the only prospective trials to date that have actually achieved systolic blood pressure levels less than 130 mmHg. In ACCORD, despite a sustained difference in blood pressure between the two treatment groups (133 mmHg versus 119 mmHg) for more than 4 years, there was no additional benefit on the primary endpoint, CV events. Of note, there was a benefit in stroke events. All physicians who manage hypertension should review the much anticipated JNC 8.