Blood Pressure and Combination Lipid Therapies do not Reduce Combined Cardiovascular Events in Adults with Diabetes
Landmark ACCORD Trial Finds Intensive Blood Pressure and Combination Lipid Therapies do not Reduce Combined Cardiovascular Events in Adults with Diabetes
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Lowering blood pressure to normal levels — below currently recommended levels — did not significantly reduce the combined risk of fatal or nonfatal cardiovascular disease events in adults with type 2 diabetes who were at especially high risk for cardiovascular disease events, according to new results from the landmark Action to Control Cardiovascular Risk in Diabetes (ACCORD) clinical trial. Similarly, treating multiple blood lipids with combination drug therapy of a fibrate and a statin did not reduce the combined risk of cardiovascular disease events more than treatment with statin alone. The study of more than 10,000 participants is sponsored by the National Institutes of Health.
ACCORD is one of the largest studies ever conducted in adults with type 2 diabetes who were at especially high risk of cardiovascular events, such as heart attacks, stroke, or death from cardiovascular disease. The multicenter clinical trial tested three potential strategies to lower the risk of major cardiovascular events: intensive control of blood sugar, intensive control of blood pressure, and treatment of multiple blood lipids. The lipids targeted for intensive treatment were high density lipoprotein (HDL) cholesterol and triglycerides, in addition to standard therapy of lowering low density lipoprotein (LDL) cholesterol.
The results of the ACCORD blood pressure and lipid clinical trials appear online in the New England Journal of Medicine (NEJM) today and will be in the April 29, 2010, NEJM print edition. The results are also being presented today at the American College of Cardiology’s 59th annual scientific session in Atlanta. Results of the ACCORD blood sugar clinical trial were reported in 2008.
“ACCORD provides important evidence to help guide treatment recommendations for adults with type 2 diabetes who have had a heart attack or stroke or who are otherwise at especially high risk for cardiovascular disease,” said Susan B. Shurin, M.D., acting director of the NIH’s National Heart, Lung, and Blood Institute (NHLBI), the primary sponsor of ACCORD. “This information provides guidance to avoid unnecessarily increasing treatment that provides limited benefit and potentially increases the risk of adverse effects.”
ACCORD researchers from 77 medical centers in the United States and Canada studied 10,251 participants between the ages of 40 and 79 who had type 2 diabetes for an average of 10 years. When they joined the study, all participants were at especially high risk of cardiovascular events because they had pre-existing cardiovascular disease, evidence of subclinical cardiovascular disease, or at least two cardiovascular disease risk factors in addition to diabetes.
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