Intensive blood-pressure (BP) lowering therapy in patients with type 2 diabetes and a yoga-based cardiac rehabilitation program for people with heart failure and reduced ejection fraction (HFrEF) were among the hot topics in cardiovascular prevention included in a late-breaking clinical science session at AHA 2026.

In the OPTIMAL-DIABETES trial, researchers in Brazil randomized nearly 9,500 patients with high BP, type 2 diabetes and at high cardiovascular risk to intensive therapy targeting a systolic BP of less than 120 mm Hg, vs. less than 140 mm Hg.

Results, simultaneously published in NEJM, showed that the intensive therapy when compared with standard therapy did not significantly reduce the occurrence of major cardiovascular events, including death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina or heart failure, over a median follow-up period of four years (6% vs. 6.7%, respectively). The rates of serious adverse events were also similar across the two groups. However, researchers noted that intensive therapy did lower the mean systolic BP (with exclusion of the first three months) compared with standard therapy.

“These findings should not be interpreted as evidence that more intensive BP lowering is ineffective for people with Type 2 diabetes. Rather, they suggest that any cardiovascular benefit may be smaller than that observed in individuals without Type 2 diabetes. As a result, even a large trial such as OPTIMAL-DIABETES may not have been able to definitively detect a modest treatment effect,” said Otavio Berwanger, MD, PhD. He adds that the study ultimately “adds an important piece to the overall evidence base and highlights the need to consider the totality of evidence, rather than any single trial alone, when defining optimal BP targets in patients with type 2 diabetes.”

In the Yoga-CaRe HF trial, researchers in India hypothesized that, among people with HFrEF, a Yoga-based cardiac rehabilitation program in comparison to enhanced standard care would reduce the occurrence of first cardiac event (death, repeat hospitalization or stroke) Over a follow-up of approximately 15 months, numerous health benefits including improvement in quality of life, exercise capacity, and quality-adjusted utility-values were observed.

These benefits were at a magnitude similar or higher than comprehensive exercise-based cardiac rehabilitation programs, according to Dorairaj Prabhakaran, MD, who presented the findings. Prabhakaran also noted that the program could be a scalable model for India and other settings.

Clinical Topics: Cardiovascular Care Team, Heart Failure and Cardiomyopathies, Prevention, Acute Heart Failure, Hypertension

Keywords: AHA Annual Scientific Sessions, AHA26, Cardiac Rehabilitation, Diabetes Mellitus, Type 2, Heart Failure, Stroke Volume, Yoga, Myocardial Infarction, Hypertension, Angina, Unstable, Stroke