Effect of Intensive Blood Pressure Control in Patients with Type 2 Diabetes Mellitus Over 9 Years of Follow ‐Up: A Subgroup Analysis of High‐Risk ACCORDION Trial Participants

Abstract Although guidelines recommend strict blood pressure (BP) control in patients with type 2 diabetes mellitus (T2DM) and elevated cardiovascular risk, the long‐term effects of this approach are unknown. We investigated the effect of intensive BP control on clinical outcomes in patients with T2DM over 9 years of follow‐up. We included ACCORD BP participants in the standard glucose control arm who had established cardiovascular disease, chronic kidney disease, age ≥75 years or 10‐year coronary heart risk ≥15%. Participants were randomized to either intensive (systolic BP <120 mm Hg) or standard (systolic BP <140 mm Hg) BP control for an average of 5 years. Observational follow‐up occurred for an average of 4 years thereafter. After an average total follow‐up of 9 years, intensive BP control reduced the composite of cardiovascular death, nonfatal myocardial infarction and nonfatal stroke by 25% (hazard ratio, 0.75; 95% confidence interval, 0.60‐0.95; P=0.02). The overall benefit was driven by a reduction in nonfatal myocardial infarction (P=0.01). In this post‐hoc analysis, the benefits of a fixed duration intensive BP control intervention in patients with T2DM persisted throughout 9 years of follow‐up.
Source: Diabetes, Obesity and Metabolism - Category: Endocrinology Authors: Tags: BRIEF REPORT Source Type: research