ACCORD BP Trial Summary: Intensive BP Control in Type 2 Diabetes
2010 ACCORD BP TRIAL Effects of intensive blood-pressure control in type 2 diabetes mellitus Multicenter, randomized, controlled, open-label trial Objective: In patients with T2DM at high risk for CV events, does intensive BP control (SBP <120 mmHg) reduce rates of nonfatal MI, nonfatal stroke, or CV mortality when compared to standard BP control (SBP <140 mmHg)? 4,733 Inclusion criteria: Patients with type 2 diabetes mellitus, hemoglobin A1C 27.5% and either active CVD or at risk for CVD. patients Intensive BP control (n=2,362) VS Conventional BP control (n=2,371) PRIMARY OUTCOME 1.87 Nonfatal MI, nonfatal stroke, or CV mortality %/yr HR 0.88; 95% CI 0.73-1.06; P=0.20 2.09 SECONDARY OUTCOME 1.13 Nonfatal MI %/yr HR 0.87; 95% CI 0.68-1.10; P=0.25 1.28 0.32 Any stroke %/yr HR 0.59; 95% CI 0.39-0.89; P=0.01; NNT 476/yr 0.53 Conclusion: In patients with type 2 diabetes at high risk for CV events, targeting a systolic blood pressure of less than 120 mm Hg, as compared with less than 140 mm Hg, did not reduce the rate of a composite outcome of fatal and nonfatal major cardiovascular events. ACCORD Study Group. NEJM, 2010. 362(17):1575-1585.