The ACCORD Blood Pressure Study: What Target for High-Risk Diabetic Patients?

In epidemiological studies, lower blood pressure (BP) is associated with lower cardiovascular risk. But, in high-risk patients, would achieving blood pressure targets lower than those recommended in guidelines reduce risk further? Researchers evaluated whether a blood pressure target of <120 mm Hg in patients with type 2 diabetes would lower risk for adverse cardiovascular events.

A total of 4733 high-risk diabetic patients (mean age, 62; 48% women; glycosylated hemoglobin, ≥7.5%; systolic blood pressure [SBP], 130–180 mm Hg) who were taking ≤3 antihypertensive medications and had no proteinuria were enrolled. Patients were assigned to intensive BP control (target SBP, <120 mm Hg) or standard BP control (target SBP, <140 mm Hg). Mean follow-…