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  • Intensive lowering of systolic blood pressure to a target of less than 120 mm Hg has no effect on the rate of fatal and non-fatal major cardiovascular events in high-risk patients with type 2 diabetes

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Therapeutics
Randomised controlled trial
Intensive lowering of systolic blood pressure to a target of less than 120 mm Hg has no effect on the rate of fatal and non-fatal major cardiovascular events in high-risk patients with type 2 diabetes
  1. Atul Chugh1,
  2. George Bakris2
  1. 1Department of Cardiology, University of Louisville Medical Center, Louisville, Kentucky, USA
  2. 2Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA
  1. Correspondence to George Bakris
    Pritzker School of Medicine, University of Chicago, 5841 S. Maryland Avenue, MC 1027, Chicago, IL 60637, USA; gbakris{at}gmail.com

https://doi.org/10.1136/ebm1099

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    Commentary on:

    1. Cushman WC,
    2. Evans GW,
    3. Byington RP,
    4. et al
    .; ACCORD Study Group. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med 2010;362:1575–85.
    OpenUrlCrossRefPubMedWeb of Science

    Context

    The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure recommends a blood pressure (BP) treatment goal of <130/80 mm Hg for patients with diabetes and hypertension.1 This goal was derived from observational data.2 3 The BP arm of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial prospectively addressed whether this lower BP further reduced cardiovascular events in high-risk patients with type 2 diabetes.

    Methods

    ACCORD was a prospective, open-label, randomised trial that enrolled 10 251 patients at high-cardiovascular risk and type 2 diabetes. Of these, 4733 patients were randomised to either intensive (goal systolic BP (SBP) <120 mm Hg) or standard (goal SBP <140 mm Hg) control in a two-by-two factorial design. High risk was defined as a …

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    Footnotes

    • Competing interests GB is a consultant for NIH/NIDDK, GSK, Merck, Novartis, Boehringer-Ingelheim, Takeda, Abbott, Walgreen's, BMS/Sanofi, Gilead, Forest, CVRx, Fibrogen, Spherix, Johnson & Johnson, Daiichi-Sankyo. GB has also received investigator initiated grants from GSK Forest Labs.