Effects of Intensive Blood Pressure Control on Cardiovascular Events in Type 2 Diabetes Mellitus: The Action to Control Cardiovascular Risk in Diabetes (ACCORD) Blood Pressure Trial. William C. Cushman, MD, FACP, FAHA Veterans Affairs Medical Center, Memphis, TN For The ACCORD Study Group.
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Effects of Intensive Blood Pressure Control on Cardiovascular Events in Type 2 Diabetes Mellitus: The Action to Control Cardiovascular Risk in Diabetes (ACCORD) Blood Pressure Trial
William C. Cushman, MD, FACP, FAHA
Veterans Affairs Medical Center, Memphis, TN
For The ACCORD Study Group
Collaboration & support
National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)
National Eye Institute (NEI)
National Institute on Aging (NIA)
Centers for Disease Control and Prevention (CDC)
Abbott Laboratories (and Fournier Laboratories)
AstraZeneca Pharmaceuticals LP
King Pharmaceuticals, Inc.
MediSense Products (division of Abbott Laboratories)
Merck & Company, Inc.
Closer Healthcare Inc.
Novartis Pharmaceuticals. Inc.
Novo Nordisk Pharmaceuticals., Inc.
Omron Healthcare, Inc.
Takeda Pharmaceuticals Inc
Sponsor: The National Heart, Lung, and Blood Institute (NHLBI)
ACCORD Study Design
ACCORD Double 2 x 2 Factorial Design
ACCORD BP Trial Eligibility
Mean # Meds
Intensive: 3.2 3.4 3.5 3.4
Standard: 1.9 2.1 2.2 2.3
Average after 1st year: 133.5 Standard vs. 119.3 Intensive, Delta = 14.2
Also examined Fatal/Nonfatal HF (HR=0.94, p=0.67), a composite of fatal coronary events, nonfatal MI and unstable angina (HR=0.94, p=0.50) and a composite of the primary outcome, revascularization and unstable angina
Nonfatal MI, Nonfatal Stroke or CVD Death
HR = 0.88
95% CI (0.73-1.06)
HR = 0.63
95% CI (0.41-0.96)
HR = 0.59
95% CI (0.39-0.89)
Primary Outcome by Pre-defined Subgroups
Also examined DBP tertiles (p=0.70) and number of screening meds (p=0.44)
Published online March 14, 2010