Yashkin AP, et al. – Researchers undertook this inquiry to gain knowledge regarding the impact of intensive drug therapy on all–cause death, congestive heart failure (CHF) and hospitalization for myocardial infarction (MI) and stroke/transient ischemic attack (stroke/TIA) in individuals age 65+ with diabetes (T2D) and hypertension. Findings demonstrated that in a high–risk population, treatment with intensive drug therapy failed to delay mortality but not severe macrovascular outcomes. In these subjects, protective impacts of intensive drug therapy likely outweighed polypharmacy–related health concerns.

Methods

• In this study, individuals from the Medicare 5% dataset with hypertension and T2D undergoing intensive drug therapy for these conditions were propensity score matched to a non-intensive-drug-therapy group.
• Also, using the Cox proportional hazard model, hazard ratios (HR) were obtained.

Results

• Findings demonstrated that intensive drug therapy was associated with increased risk of CHF [HR: 2.32; 95% Confidence Interval (CI): 2.32–2.38], MI [HR: 4.27; CI: 4.05–4.52], and stroke/TIA [HR: 1.80; CI: 1.70–1.89] but decreased risk of death [HR: 0.95; CI: 0.93–0.97].
• Researchers observed that risk for CHF [HR: 0.73; CI: 0.71–0.73], MI [HR: 0.64; CI: 0.62–0.67], stroke/TIA [HR: 0.82; CI: 0.78–0.86] and death [HR: 0.29; CI: 0.28–0.29] was decreased by adherence to diabetes management guidelines.