Trial reportDiabetes care2012
Intensive blood pressure treatment does not improve cardiovascular outcomes in centrally obese hypertensive individuals with diabetes: the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Blood Pressure Trial.
Trial report in Diabetes care, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Insulin and glucose-lowering agents for treating people with diabetes and chronic kidney disease.The Cochrane database of systematic reviews · 2018Pooled it
- Glucose targets for preventing diabetic kidney disease and its progression.The Cochrane database of systematic reviews · 2017Pooled it
- Guideline
- Comprehensive Cardiovascular Risk Factor Control Improves Survival: The BARI 2D Trial.Journal of the American College of Cardiology · 2015Trial
- Effect of intensive and standard blood pressure control on cardiovascular outcomes based on body mass index: sub-analysis of the sprint trial.Journal of human hypertension · 2020Article
- Improving obesity and blood pressure.Hypertension research : official journal of the Japanese Society of Hypertension · 2020Review
- Blood pressure targets for hypertension in patients with type 2 diabetes.Annals of translational medicine · 2018Article
- Association of Blood Pressure Control Level With Left Ventricular Morphology and Function and With Subclinical Cerebrovascular Disease.Journal of the American Heart Association · 2017Article
- Hypertension Management in Diabetic Kidney Disease.Diabetes spectrum : a publication of the American Diabetes Association · 2015Article
- Update on blood pressure goals in diabetes mellitus.Current cardiology reports · 2015Review
- Association between insufficient medication of antihypertensives and the severity of acute ischemic stroke.Clinical hypertension · 2015Article
- Blood pressure and mortality in U.S. veterans with chronic kidney disease: a cohort study.Annals of internal medicine · 2013Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 2 countries.
Funding
Abstract
objectiveThe Action to Control Cardiovascular Risk in Diabetes (ACCORD) Blood Pressure Trial reported no differences in most cardiovascular disease (CVD) outcomes between intensive and standard blood pressure therapy in individuals with diabetes mellitus (DM) and hypertension. Many such individuals are centrally obese. Here we evaluate whether the trial outcomes varied by the level of central obesity. RESEARCH DESIGN AND
methodsThe cohort included 4,687 people (47.7% women) with DM and hypertension. Mean age was 62.2, and mean follow-up was 4.7 years. Participants were randomly assigned to one of two blood pressure treatment strategies: intensive (systolic <120 mmHg) or standard (systolic <140 mmHg). Sex-specific quartiles of waist-to-height ratio were used as the measure of central obesity. The primary ACCORD outcome (a composite of nonfatal myocardial infarction [MI], nonfatal stroke, or CVD death) and three secondary outcomes (nonfatal MI, fatal or nonfatal stroke, and CVD death) were examined using proportional hazard models.
resultsThere was no evidence that the effect of intensively lowering blood pressure differed by quartile of waist-to-height ratio for any of the four outcomes (P > 0.25 in all cases). Controlling for waist-to-height quartile had no significant impact on previously published results for intensive blood pressure therapy. Waist-to-height ratio was significantly related to CVD mortality (hazard ratio 2.32 [95% CI 1.40-3.83], P = 0.0009 comparing the heaviest to lightest quartiles), but not to the other outcomes (P > 0.09 in all cases).
conclusionsIntensive lowering of blood pressure versus standard treatment does not ameliorate CVD risk in individuals with DM and hypertension. These results did not vary by quartile of waist-to-height ratio.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.