伊利诺伊州芝加哥美国心脏协会年会OPTIMAL-DIABETES试验：9476名2型糖尿病患者强化降压至120以下未显著减少心血管事件，发生率6%对6.7%
伊利诺伊州库克县芝加哥市消息—11月7日在芝加哥举行的美国心脏协会2026年科学年会（Scientific Sessions 2026）上公布的 OPTIMAL-DIABETES 试验结果显示，对心血管风险升高的2型糖尿病成年人把收缩压强化降至120毫米汞柱以下，与降至140毫米汞柱以下的标准治疗相比，未显著减少心血管死亡、卒中、心肌梗死等心血管事件的发生。该结果同日在《新英格兰医学杂志》全文发表。
据美国心脏病学会的会议报道，该试验在巴西33个中心随机入组9476名50岁及以上成年人，平均年龄65岁，入组时收缩压在130至180毫米汞柱之间、患有2型糖尿病并伴其他心血管风险因素；受试者于2019年8月至2021年10月入组，中位随访4年。主要复合终点（心血管死亡、非致死性心肌梗死、非致死性卒中，以及因不稳定性心绞痛或心力衰竭住院）在强化组发生率为6%、标准组为6.7%，差异无统计学显著性；研究方同时报告，剔除最初3个月后，强化组的平均收缩压低于标准组。
研究主要作者为巴西圣保罗爱因斯坦医院学术研究组织的卡拉·桑托（Karla Santo）；研究者奥塔维奥·贝万格（Otavio Berwanger）表示，这一结果不应解读为强化降压对2型糖尿病患者无效，而提示其心血管获益可能小于非糖尿病人群，即便如此大规模的试验也未必能确切检出较小的治疗效应。
OPTIMAL-DIABETES Trial at AHA Scientific Sessions in Chicago, Illinois: Intensive Blood Pressure Target Below 120 Did Not Significantly Cut Cardiovascular Events in 9,476 Adults With Type 2 Diabetes, 6% Versus 6.7%
CHICAGO, Cook County, Illinois — Results of the OPTIMAL-DIABETES trial, presented on November 7 at the American Heart Association's Scientific Sessions 2026 in Chicago, showed that intensive blood pressure lowering to a systolic target below 120 mm Hg, compared with standard treatment targeting below 140 mm Hg, did not significantly reduce cardiovascular death, stroke, heart attack and other cardiovascular events in adults with type 2 diabetes at increased cardiovascular risk. The results were published simultaneously as a full manuscript in the New England Journal of Medicine.
According to the American College of Cardiology's meeting coverage, the trial randomly assigned 9,476 adults aged 50 and older — average age 65 — at 33 sites in Brazil. Participants had systolic blood pressure between 130 and 180 mm Hg, type 2 diabetes and additional cardiovascular risk factors; they were enrolled from August 2019 to October 2021 and followed for a median of four years. The primary composite outcome of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina or heart failure occurred in 6% of the intensive group versus 6.7% of the standard group, a difference that was not statistically significant. The researchers also reported that mean systolic blood pressure, excluding the first three months, was lower in the intensive group.
The lead study author was Karla Santo, M.D., Ph.D., of the Academic Research Organization of Einstein Hospital Israelita in S?o Paulo, Brazil. Investigator Otavio Berwanger, M.D., Ph.D., said the findings should not be interpreted as evidence that more intensive blood pressure lowering is ineffective for people with type 2 diabetes, but rather suggest that any cardiovascular benefit may be smaller than in individuals without diabetes, so that even a large trial may not definitively detect a modest effect. This report presents only the published trial data and the investigators' statements and does not constitute medical advice for any individual.
来源链接：美国心脏病学会会议报道（acc.org）： https://www.acc.org/latest-in-cardiology/articles/2026/11/06/14/37/sat-5pm-yoga-aha-2026
来源：美国心脏协会
发布：GSM·美国（发布链接）
图片来源：图：血压测量。https://www.myupchar.com/en 摄，CC BY-SA 4.0，经 Wikimedia Commons。 / Photo: Blood pressure measurement. Photo by https://www.myupchar.com/en, CC BY-SA 4.0, via Wikimedia Commons.
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