ACCORDION: What Are the Effects of Long-Term Intensive BP Treatment in Diabetes Patients?

Intensive blood pressure (BP) lowering did not reduce the rate of a composite of fatal and non-fatal major cardiovascular events or mortality over a median follow-up of 8.8 years in patients with type 2 diabetes and high cardiovascular risk, according to results from the ACCORDION trial presented Nov. 10 during AHA 2015 in Orlando.

The trial looked at 3,957 participants from the ACCORD BP trial, who were followed for an additional five years. Results showed that during a median follow-up period of 8.8 years from randomization of intensive (systolic BP [SBP] <120 mm Hg) or standard (SBP <140 mm Hg) treatment, the annual rate of the primary outcome – a composite of non-fatal major cardiovascular events or cardiovascular death – was 2.03 percent in the intensive group and 2.22 percent in the standard group.

However, the investigators note that "with long term follow-up, a significant interaction between BP and glycemia interventions was observed, with evidence of benefit for intensive BP lowering in participants randomized to standard glycemia therapy (HR=0.79, 95 percent CI 0.65 – 0.96)."

They add that the stroke benefit observed during the intervention did not persist after BP differences waned,"and that this result further shows "that the BP-stroke relationship observed during ACCORD was real."

Clinical Topics: Diabetes and Cardiometabolic Disease

Keywords: AHA Annual Scientific Sessions, Blood Glucose, Blood Pressure, Diabetes Mellitus, Type 2, Hypotension, Stroke, Metabolic Syndrome X


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