Intensive Versus Standard Blood Pressure Control in SPRINT-Eligible Participants of ACCORD-BP
© 2017 by the American Diabetes Association..
OBJECTIVE: We sought to determine the effect of intensive blood pressure (BP) control on cardiovascular outcomes in participants with type 2 diabetes mellitus (T2DM) and additional risk factors for cardiovascular disease (CVD).
RESEARCH DESIGN AND METHODS: This study was a post hoc, multivariate, subgroup analysis of ACCORD-BP (Action to Control Cardiovascular Risk in Diabetes Blood Pressure) participants. Participants were eligible for the analysis if they were in the standard glucose control arm of ACCORD-BP and also had the additional CVD risk factors required for SPRINT (Systolic Blood Pressure Intervention Trial) eligibility. We used a Cox proportional hazards regression model to compare the effect of intensive versus standard BP control on CVD outcomes. The "SPRINT-eligible" ACCORD-BP participants were pooled with SPRINT participants to determine whether the effects of intensive BP control interacted with T2DM.
RESULTS: The mean baseline Framingham 10-year CVD risk scores were 14.5% and 14.8%, respectively, in the intensive and standard BP control groups. The mean achieved systolic BP values were 120 and 134 mmHg in the intensive and standard BP control groups (P < 0.001). Intensive BP control reduced the composite of CVD death, nonfatal myocardial infarction (MI), nonfatal stroke, any revascularization, and heart failure (hazard ratio 0.79; 95% CI 0.65-0.96; P = 0.02). Intensive BP control also reduced CVD death, nonfatal MI, and nonfatal stroke (hazard ratio 0.69; 95% CI 0.51-0.93; P = 0.01). Treatment-related adverse events occurred more frequently in participants receiving intensive BP control (4.1% vs. 2.1%; P = 0.003). The effect of intensive BP control on CVD outcomes did not differ between patients with and without T2DM (P > 0.62).
CONCLUSIONS: Intensive BP control reduced CVD outcomes in a cohort of participants with T2DM and additional CVD risk factors.
| Errataetall: |
CommentIn: Diabetes Care. 2018 Jun;41(6):e84-e85. - PMID 29784700 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:40 |
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| Enthalten in: |
Diabetes care - 40(2017), 12 vom: 01. Dez., Seite 1733-1738 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Buckley, Leo F [VerfasserIn] |
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| Links: |
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| Themen: |
Antihypertensive Agents |
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| Anmerkungen: |
Date Completed 09.02.2018 Date Revised 21.03.2022 published: Print-Electronic CommentIn: Diabetes Care. 2018 Jun;41(6):e84-e85. - PMID 29784700 Citation Status MEDLINE |
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| doi: |
10.2337/dc17-1366 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 500 | |a CommentIn: Diabetes Care. 2018 Jun;41(6):e84-e85. - PMID 29784700 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2017 by the American Diabetes Association. | ||
| 520 | |a OBJECTIVE: We sought to determine the effect of intensive blood pressure (BP) control on cardiovascular outcomes in participants with type 2 diabetes mellitus (T2DM) and additional risk factors for cardiovascular disease (CVD) | ||
| 520 | |a RESEARCH DESIGN AND METHODS: This study was a post hoc, multivariate, subgroup analysis of ACCORD-BP (Action to Control Cardiovascular Risk in Diabetes Blood Pressure) participants. Participants were eligible for the analysis if they were in the standard glucose control arm of ACCORD-BP and also had the additional CVD risk factors required for SPRINT (Systolic Blood Pressure Intervention Trial) eligibility. We used a Cox proportional hazards regression model to compare the effect of intensive versus standard BP control on CVD outcomes. The "SPRINT-eligible" ACCORD-BP participants were pooled with SPRINT participants to determine whether the effects of intensive BP control interacted with T2DM | ||
| 520 | |a RESULTS: The mean baseline Framingham 10-year CVD risk scores were 14.5% and 14.8%, respectively, in the intensive and standard BP control groups. The mean achieved systolic BP values were 120 and 134 mmHg in the intensive and standard BP control groups (P < 0.001). Intensive BP control reduced the composite of CVD death, nonfatal myocardial infarction (MI), nonfatal stroke, any revascularization, and heart failure (hazard ratio 0.79; 95% CI 0.65-0.96; P = 0.02). Intensive BP control also reduced CVD death, nonfatal MI, and nonfatal stroke (hazard ratio 0.69; 95% CI 0.51-0.93; P = 0.01). Treatment-related adverse events occurred more frequently in participants receiving intensive BP control (4.1% vs. 2.1%; P = 0.003). The effect of intensive BP control on CVD outcomes did not differ between patients with and without T2DM (P > 0.62) | ||
| 520 | |a CONCLUSIONS: Intensive BP control reduced CVD outcomes in a cohort of participants with T2DM and additional CVD risk factors | ||
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| 700 | 1 | |a Baker, William L |e verfasserin |4 aut | |
| 700 | 1 | |a Van Tassell, Benjamin W |e verfasserin |4 aut | |
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