Table S1. Relative risk of patient outcomes depending on baseline or attained blood pressure in adults with diabetes, the results from meta-analyses of aggregate data from randomized controlled clinical trials.
| Outcome | Blood pressure | Relative risk | No. of participants (studies) |
|---|---|---|---|
| Meta-regression of aggregate data by baseline blood pressure | |||
| All-cause mortality | 10 mmHg lower baseline SBP | 1.04 (0.98–1.10) | 73,738 (49 RCTs) (31) |
| All-cause mortality | 10 mmHg lower baseline DBP | 1.08 (0.99–1.18) | 73,738 (49 RCTs) (31) |
| Cardiovascular mortality | 10 mmHg lower baseline SBP | 1.15 (1.03–1.29) | 73,738 (49 RCTs) (31) |
| Cardiovascular mortality | 10 mmHg lower baseline DBP | 1.28 (1.05–1.55) | 73,738 (49 RCTs) (31) |
| End-stage renal disease | 10 mmHg lower baseline SBP | 1.05 (0.90–1.22) | 73,738 (49 RCTs) (31) |
| End-stage renal disease | 10 mmHg lower baseline DBP | 1.13 (0.88–1.44) | 73,738 (49 RCTs) (31) |
| Heart failure | 10 mmHg lower baseline SBP | 1.05 (0.93–1.20) | 73,738 (49 RCTs) (31) |
| Heart failure | 10 mmHg lower baseline DBP | 1.11 (0.90–1.36) | 73,738 (49 RCTs) (31) |
| Myocardial infarction | 10 mmHg lower baseline SBP | 1.12 (1.03–1.22) | 73,738 (49 RCTs) (31) |
| Myocardial infarction | 10 mmHg lower baseline DBP | 1.11 (0.98–1.26) | 73,738 (49 RCTs) (31) |
| Stroke | 10 mmHg lower baseline SBP | 1.07 (0.98–1.18) | 73,738 (49 RCTs) (31) |
| Stroke | 10 mmHg lower baseline DBP | 1.09 (0.93–1.27) | 73,738 (49 RCTs) (31) |
| Subgroup meta-analysis of aggregate data by baseline blood pressure | |||
| All-cause mortality | Baseline SBP >150 mmHg | 0.89 (0.80–0.99) | 12,824 (16 RCTs) (31) |
| Cardiovascular mortality | Baseline SBP >150 mmHg | 0.75 (0.57–0.99) | 9,073 (11 RCTs) (31) |
| Myocardial infarction | Baseline SBP >150 mmHg | 0.74 (0.63–0.87) | 9,914 (13 RCTs) (31) |
| Stroke | Baseline SBP >150 mmHg | 0.77 (0.65–0.91) | 11,444 (15 RCTs) (31) |
| Heart failure | Baseline SBP >150 mmHg | 0.73 (0.53–1.01) | 6,510 (7 RCTs) (31) |
| End-stage renal disease | Baseline SBP >150 mmHg | 0.82 (0.71–0.94) | 4,814 (5 RCTs) (31) |
| All-cause mortality | Baseline SBP 140–150 mmHg | 0.87 (0.78–0.98) | 24,652 (10 RCTs) (31) |
| All-cause mortality | Baseline SBP >140mmHg | 0.73 (0.64–0.84) | 30,998 (13 RCT) (93) |
| Cardiovascular mortality | Baseline SBP 140–150 mmHg | 0.87 (0.71–1.05) | 24,243 (9 RCTs) (31) |
| Cardiovascular disease | Baseline SBP >140mmHg | 0.74 (0.65–0.85) | 29,044 (11RCT) (93) |
| Myocardial infarction | Baseline SBP 140–150 mmHg | 0.84 (0.76–0.93) | 23,286 (7 RCTs) (31) |
| Stroke | Baseline SBP 140–150 mmHg | 0.92 (0.83–1.01) | 30,135 (9 RCTs) (31) |
| Stroke | Baseline SBP >140mmHg | 0.74 (0.74–0.86) | 36,934 (14 RCT) (93) |
| Heart failure | Baseline SBP 140–150 mmHg | 0.80 (0.66–0.97) | 12,723 (7 RCTs) (31) |
| End-stage renal disease | Baseline SBP 140–150 mmHg | 0.91 (0.74–1.12) | 21,376 (6 RCTs) (31) |
| All-cause mortality | Baseline SBP <140 mmHg | 1.05 (0.95–1.16) | 24,350 (14 RCTs) (31) |
| All-cause mortality | Baseline SBP <140 mmHg | 1.07 (0.92–1.26) | 12,559 (7 RCTs) (93) |
| Cardiovascular mortality | Baseline SBP <140 mmHg | 1.15 (1.00–1.32) | 22,439 (10 RCTs) (31) |
| Cardiovascular disease | Baseline SBP <140 mmHg | 0.96 (0.88–1.05) | 21,574 (6 RCTs) (93) |
| Myocardial infarction | Baseline SBP <140 mmHg | 1.00 (0.87–1.15) | 18,051 (9 RCTs) (31) |
| Stroke | Baseline SBP <140 mmHg | 0.81 (0.53–1.22) | 17,911 (8 RCTs) (31) |
| Stroke | Baseline SBP <140 mmHg | 0.69 (0.69–0.92) | 17,127 (5 RCT) (93) |
| Heart failure | Baseline SBP <140 mmHg | 0.90 (0.79–1.02) | 17,392 (8 RCTs) (31) |
| End-stage renal disease | Baseline SBP <140 mmHg | 0.97 (0.80–1.17) | 19,973 (7 RCTs) (31) |
| Cardiovascular mortality | Baseline SBP <130 mmHg | 2.95 (0.43–20.20) | 4,946 (2 RCTs) (37) |
| All-cause mortality | Baseline DBP >90 mmHg | 0.85 (0.73–1.00) | 6,591 (9 RCTs) (31) |
| Cardiovascular mortality | Baseline DBP >90 mmHg | 0.70 (0.55–0.89) | 4,452 (6 RCTs) (31) |
| Myocardial infarction | Baseline DBP >90 mmHg | 0.79 (0.62–1.00) | 3,681 (6 RCTs) (31) |
| Stroke | Baseline DBP >90 mmHg | 0.74 (0.58–0.94) | 5,211 (8 RCTs) (31) |
| Heart failure | Baseline DBP >90 mmHg | 0.50 (0.29–0.85) | 1,259 (2 RCTs) (31) |
| End-stage renal disease | Baseline DBP >90 mmHg | 0.96 (0.14–6.76) | 1,259 (2 RCTs) (31) |
| All-cause mortality | Baseline DBP 80–90 mmHg | 0.90 (0.82–0.99) | 25,779 (16 RCTs) (31) |
| Cardiovascular mortality | Baseline DBP 80–90 mmHg | 0.91 (0.78–1.07) | 24,842 (13 RCTs) (31) |
| Myocardial infarction | Baseline DBP 80–90 mmHg | 0.85 (0.76–0.95) | 24,861 (13 RCTs) (31) |
| Stroke | Baseline DBP 80–90 mmHg | 0.92 (0.83–1.03) | 30,604 (14 RCTs) (31) |
| Heart failure | Baseline DBP 80–90 mmHg | 0.81 (0.67–0.97) | 13,322 (11 RCTs) (31) |
| End-stage renal disease | Baseline DBP 80–90 mmHg | 0.83 (0.72–0.94) | 20,912 (8 RCTs) (31) |
| All-cause mortality | Baseline DBP <80 mmHg | 0.97 (0.89–1.06) | 29,456 (15 RCTs) (31) |
| Cardiovascular mortality | Baseline DBP <80 mmHg | 1.08 (0.82–1.41) | 27,091 (11 RCTs) (31) |
| Myocardial infarction | Baseline DBP <80 mmHg | 0.90 (0.79–1.02) | 22,709 (10 RCTs) (31) |
| Stroke | Baseline DBP <80 mmHg | 0.86 (0.70–1.05) | 23,675 (10 RCTs) (31) |
| Heart failure | Baseline DBP <80 mmHg | 0.89 (0.80–1.00) | 22,044 (9 RCTs) (31) |
| End-stage renal disease | Baseline DBP <80 mmHg | 0.97 (0.83–1.13) | 23,992 (8 RCTs) (31) |
| Meta-regression of aggregate data by attained blood pressure | |||
| All-cause mortality | Each 10 mmHg lower attained SBP | 0.94 (0.89–0.99) | 53,344 (20 RCTs) (33) |
| All-cause mortality | Each 10 mmHg lower attained SBP | 1.02 (0.93–1.12) | 73,738 (49 RCTs) (31) |
| All-cause mortality | Each 10 mmHg lower attained DBP | 1.07 (0.93–1.23) | 73,738 (49 RCTs) (31) |
| Cardiovascular mortality | Each 10 mmHg lower attained SBP | 1.20 (0.99–1.44) | 73,738 (49 RCTs) (31) |
| Cardiovascular mortality | Each 10 mmHg lower attained DBP | 1.35 (0.98–1.86) | 73,738 (49 RCTs) (31) |
| Coronary heart disease | Each 10 mmHg lower attained SBP | 0.88 (0.80–0.97) | 52,129 (19 RCTs) (33) |
| Major cardiovascular events | Each 10 mmHg lower attained SBP | 0.88 (0.82–0.94) | 59,773 (23 RCTs) (33) |
| Myocardial infarction | Each 10 mmHg lower attained SBP | 1.09 (0.98–1.21) | 73,738 (49 RCTs) (31) |
| Myocardial infarction | Each 10 mmHg lower attained DBP | 1.13 (0.96–1.33) | 73,738 (49 RCTs) (31) |
| Heart failure | Each 10 mmHg lower attained SBP | 0.90 (0.83–0.98) | 41,960 (13 RCTs) (33) |
| Heart failure | Each 10 mmHg lower attained SBP | 1.05 (0.90–1.22) | 73,738 (49 RCTs) (31) |
| Heart failure | Each 10 mmHg lower attained DBP | 1.11 (0.90–1.36) | 73,738 (49 RCTs) (31) |
| End-stage renal disease | Each 10 mmHg lower attained SBP | 1.02 (0.85–1.24) | 73,738 (49 RCTs) (31) |
| End-stage renal disease | Each 10 mmHg lower attained DBP | 1.11 (0.88–1.41) | 73,738 (49 RCTs) (31) |
| Renal failure | Each 10 mmHg lower attained SBP | 0.92 (0.84–1.01) | 28,190 (9 RCTs) (33) |
| Stroke | Each 10 mmHg lower attained SBP | 0.74 (0.65–0.84) | 58,064 (21 RCTs) (33) |
| Stroke | Each 10 mmHg lower attained SBP | 0.97 (0.82–1.13) | 73,738 (49 RCTs) (31) |
| Stroke | Each 10 mmHg lower attained DBP | 0.95 (0.75–1.21) | 73,738 (49 RCTs) (31) |
| Subgroup meta-analysis of aggregate data by attained blood pressure | |||
| All-cause mortality | – | 0.92 (0.87–0.96) | 66,130 (45 RCTs) (31) |
| All-cause mortality | Attained SBP >140 | 0.96 (0.86–1.06) | 21,876 (13 RCTs) (31) |
| All-cause mortality** | Attained SBP ≥140 | 0.98 (0.89–1.07) | 11,559 (9 RCTs) (37) |
| All-cause mortality** | Attained SBP 130–139 | 0.85 (0.78–0.92) | 23,714 (11 RCTs) (37) |
| All-cause mortality* | Attained SBP 130–139 | 0.81 (0.49–1.35) | 1,654 (4 RCTs) (37) |
| All-cause mortality | Attained SBP 130–140 | 0.86 (0.79–0.93) | 28,900 (18 RCTs) (31) |
| All-cause mortality** | Attained SBP <130 | 1.00 (0.82–1.21) | 6,117 (2 RCTs) (37) |
| All-cause mortality* | Attained SBP <130 | 1.44 (0.81–2.57) | 4,946 (2 RCTs) (37) |
| All-cause mortality | Attained SBP <130 | 1.10 (0.91–1.33) | 11,050 (9 RCTs) (31) |
| All-cause mortality | Attained DBP >80 mmHg | 0.95 (0.86–1.06) | 13,092 (13 RCTs) (31) |
| All-cause mortality | Attained DBP 75–80 mmHg | 0.86 (0.75–0.98) | 14,059 (13 RCTs) (31) |
| All-cause mortality | Attained DBP <75 | 0.97 (0.89–1.04) | 34,675 (14 RCTs) (31) |
| Cardiovascular mortality | – | 0.92 (0.82–1.03) | 59,956 (33 RCTs) (31) |
| Cardiovascular mortality | Attained SBP >140 | 0.87 (0.71–1.07) | 20,703 (11 RCTs) (31) |
| Cardiovascular mortality** | Attained SBP ≥140 | 0.92 (0.75–1.13) | 10,386 (10 RCTs) (37) |
| Cardiovascular mortality** | Attained SBP 130–139 | 0.79 (0.67–0.93) | 22,942 (7 RCTs) (37) |
| Cardiovascular mortality* | Attained SBP 130–139 | 0.61 (0.15–2.47) | 2459 (4 RCTs) (37) |
| Cardiovascular mortality | Attained SBP 130–140 | 0.86 (0.72–1.04) | 25,095 (12 RCTs) (31) |
| Cardiovascular mortality** | Attained SBP <130 | 1.12 (0.77–1.63) | 6,117 (2 RCTs) (37) |
| Cardiovascular mortality | Attained SBP <130 mmHg | 1.26 (0.89–1.77) | 10,587 (7 RCTs) (31) |
| Cardiovascular mortality | Attained DBP >80 mmHg | 0.71 (0.53–0.97) | 11,229 (10 RCTs) (31) |
| Cardiovascular mortality | Attained DBP 75–80 mmHg | 0.85 (0.69–1.05) | 13,040 (10 RCTs) (31) |
| Cardiovascular mortality | Attained DBP <75 mmHg | 1.16 (0.92–1.47) | 32,116 (10 RCTs) (31) |
| Coronary heart disease** | Attained SBP ≥140 | 0.72 (0.60–0.85) | 11,559 (9 RCTs) (37) |
| Coronary heart disease** | Attained SBP 130–139 | 0.86 (0.78–0.94) | 22,942 (10 RCTs) (37) |
| Coronary heart disease* | Attained SBP 130–139 | 0.67 (0.29–1.55) | 1,274 (3 RCTs) (37) |
| Coronary heart disease* | Attained SBP <130 | 0.67 (0.40–1.14) | 4,946 (2 RCTs) (37) |
| Myocardial infarction | – | 0.87 (0.81–0.94) | 53,512 (31 RCTs) (31) |
| Myocardial infarction | Attained SBP >140 mmHg | 0.82 (0.72–0.92) | 21,286 (12 RCTs) (31) |
| Myocardial infarction | Attained SBP 130–140 mmHg | 0.88 (0.79–0.97) | 23,828 (11 RCTs) (31) |
| Myocardial infarction | Attained SBP <130 mmHg | 0.94 (0.76–1.15) | 6,137 (6 RCTs) (31) |
| Myocardial infarction | Attained DBP >80 mmHg | 0.76 (0.63–0.93) | 9,608 (8 RCTs) (31) |
| Myocardial infarction | Attained DBP 75–80 mmHg | 0.81 (0.72–0.91) | 13,650 (12 RCTs) (31) |
| Myocardial infarction | Attained DBP <75 mmHg | 0.95 (0.84–1.07) | 27,993 (9 RCTs) (31) |
| Heart failure | – | 0.82 (0.75–0.89) | 40,196 (25 RCTs) (31) |
| Heart failure | Attained SBP >140 mmHg | 0.83 (0.68–1.00) | 19,060 (9 RCTs) (31) |
| Heart failure** | Attained SBP ≥140 | 0.86 (0.70–1.05) | 8,743 (5 RCTs) (37) |
| Heart failure | Attained SBP 130–140 mmHg | 0.81 (0.70–0.94) | 11,568 (8 RCTs) (31) |
| Heart failure** | Attained SBP 130–139 | 0.82 (0.69–0.97) | 20,952 (8 RCTs) (37) |
| Heart failure | Attained SBP <130 mmHg | 0.93 (0.71–1.21) | 5,997 (5 RCTs) (31) |
| Heart failure** | Attained SBP <130 | 0.89 (0.65–1.23) | 6,117 (2 RCTs) (37) |
| Heart failure | Attained DBP >80 mmHg | 0.72 (0.45–1.15) | 7,656 (5 RCTs) (31) |
| Heart failure | Attained DBP 75–80 mmHg | 0.79 (0.65–0.96) | 11,135 (9 RCTs) (31) |
| Heart failure | Attained DBP <75 mmHg | 0.90 (0.79–1.01) | 17,834 (8 RCTs) (31) |
| Stroke | – | 0.87 (0.79–0.96) | 59,490 (32 RCTs) (31) |
| Stroke** | Attained SBP ≥140 mmHg | 0.89 (0.74–1.07) | 11,730 (10 RCTs) (37) |
| Stroke | Attained SBP >140 mmHg | 0.90 (0.76–1.06) | 22,045 (14 RCTs) (31) |
| Stroke | Attained SBP 130–140 mmHg | 0.91 (0.83–1.00) | 30,342 (12 RCTs) (31) |
| Stroke** | Attained SBP 130–139 | 0.85 (0.75–0.96) | 28,685 (11 RCTs) (37) |
| Stroke* | Attained SBP 130–139 | 0.89 (0.45–1.78) | 1,274 (3 RCTs) (37) |
| Stroke** | Attained SBP <130 | 0.66 (0.49–0.88) | 5,839 (3 RCTs) (37) |
| Stroke* | Attained SBP <130 | 1.36 (0.55–3.39) | 4,946 (2 RCTs) (37) |
| Stroke | Attained SBP <130 mmHg | 0.65 (0.42–0.99) | 7,103 (6 RCTs) (31) |
| Stroke | Attained DBP >80 mmHg | 0.87 (0.73–1.04) | 11,011 (10 RCTs) (31) |
| Stroke | Attained DBP 75–80 mmHg | 0.86 (0.75–0.97) | 19,380 (12 RCTs) (31) |
| Stroke | Attained DBP <75 mmHg | 0.87 (0.70–1.08) | 29,099 (10 RCTs) (31) |
| Stroke + CHD** | Attained SBP ≥140 | 0.80 (0.71–0.90) | 11,568 (9 RCTs) (37) |
| Stroke + CHD** | Attained SBP 130–139 | 0.85 (0.78–0.91) | 25,060 (11 RCTs) (37) |
| Stroke + CHD* | Attained SBP 130–139 | 0.73 (0.51–1.04) | 2,858 (5 RCTs) (37) |
| Stroke + CHD* | Attained SBP <130 | 0.80 (0.51–1.26) | 4,946 (2 RCTs) (37) |
| Stroke + CHD + HF** | Attained SBP ≥140 | 0.85 (0.74–0.97) | 9,003 (7 RCTs) (37) |
| Stroke + CHD + HF** | Attained SBP 130–139 | 0.87 (0.80–0.94) | 30,032 (12 RCTs) (37) |
| Stroke + CHD + HF* | Attained SBP <130 | 0.84 (0.60–1.19) | 862 (2 RCTs) (37) |
| End-stage renal disease | – | 0.88 (0.80–0.97) | 47,439 (18 RCTs) (31) |
| End-stage renal disease | Attained SBP >140 mmHg | 0.88 (0.76–1.03) | 18,287 (7 RCTs) (31) |
| End-stage renal disease | Attained SBP 130–140 mmHg | 0.84 (0.66–1.07) | 17,912 (6 RCTs) (31) |
| End-stage renal disease | Attained SBP <130 mmHg | 1.01 (0.71–1.43) | 9,964 (5 RCTs) (31) |
| End-stage renal disease | Attained DBP >80 mmHg | 0.77 (0.39–1.52) | 6,171 (3 RCTs) (31) |
| End-stage renal disease | Attained DBP 75–80 mmHg | 0.81 (0.71–0.93) | 8,437 (7 RCTs) (31) |
| End-stage renal disease | Attained DBP <75 mmHg | 0.98 (0.84–1.14) | 31,555 (8 RCTs) (31) |
*, low/moderate cardiovascular risk; **,high/very high cardiovascular risk. CHD, coronary heart disease; DBP, diastolic blood pressure; HF, heart failure; RCT, randomized controlled trial; RR, relative risk; SBP, systolic blood pressure.