See also:
All hypertension clinical trials
All clinical trials of strategy
All clinical trials of more intensive blood pressure lowering strategie
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ACCORD blood pressure study, 2008
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[NCT00000620]
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Treatments
Studied treatment |
intensive therapy, targeting a systolic pressure of less than 120 mm Hg
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Control treatment |
standard therapy, targeting a systolic pressure of less than 140 mm Hg
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Treatments description |
Achieved systolic blood |
119.3 / 133.5 mmHg |
Achieved diastolic blood pressure |
64.4 / 70.5 mmHg |
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Patients
Patients |
patients with a median glycated hemoglobin level of 8.1% at high risk for cardiovascular events |
Inclusion criteria |
40 years of age or older with cardiovascular disease or 55 years of age or older with anatomical evidence of a substantial amount of atherosclerosis, albuminuria, left ventricular hypertrophy, or at least two additional risk factors for cardiovascular disease (dyslipidemia, hypertension, smoking, or obesity) |
Exclusion criteria |
body-mass index of more than 45, serum creatinine level of more than 1.5 mg per deciliter; other serious illness |
Baseline characteristics |
Age (mean), years |
62.2y |
female (%) |
47.7% |
SBP |
139.2 mmHg |
DBP |
76.0 mmHg |
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Method and design
Randomized effectives |
2362 / 2371 (studied vs. control) |
Design |
Factorial plan |
Blinding |
open |
Follow-up duration |
4.7y |
Number of centre |
77 |
Geographic area |
USA, Canada |
Hypothesis |
Superiority |
Primary endpoint |
cardiovascular events |
Results
Endpoint
Studied treat. n/N
Control treat. n/N
Graph
RR [95% CI]
Cardiovascular death
60 / 2362
58 / 2371
1,04 [0,73;1,48]
Serious adverse event
77 / 2362
30 / 2371
classic
2,58 [1,70;3,91]
Heart failure
83 / 2362
90 / 2371
0,93 [0,69;1,24]
All cause death
150 / 2362
144 / 2371
1,05 [0,84;1,30]
myocardial infarction (fatal and non fatal)
126 / 2362
146 / 2371
0,87 [0,69;1,09]
stroke (fatal and non fatal)
36 / 2362
62 / 2371
0,58 [0,39;0,88]
Major cardiovascular events
208 / 2362
237 / 2371
0,88 [0,74;1,05]
0
2
1.0
Relative risks
|
Endpoint |
Events (%) |
Relative Risk |
95% CI |
Endpoint definition in the trial |
Ref |
Studied treat. |
Control treat. |
Cardiovascular death
|
60 / 2362 (2,5%) |
58 / 2371 (2,4%) |
1,04 |
[0,73;1,48] |
|
|
myocardial infarction (fatal and non fatal)
|
126 / 2362 (5,3%) |
146 / 2371 (6,2%) |
0,87 |
[0,69;1,09] |
non fatal MI |
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stroke (fatal and non fatal)
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36 / 2362 (1,5%) |
62 / 2371 (2,6%) |
0,58 |
[0,39;0,88] |
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Major cardiovascular events
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208 / 2362 (8,8%) |
237 / 2371 (10,0%) |
0,88 |
[0,74;1,05] |
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All cause death
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150 / 2362 (6,4%) |
144 / 2371 (6,1%) |
1,05 |
[0,84;1,30] |
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Serious adverse event
|
77 / 2362 (3,3%) |
30 / 2371 (1,3%) |
2,58 |
[1,70;3,91] |
attributed to blood-pressure medications |
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Heart failure
|
83 / 2362 (3,5%) |
90 / 2371 (3,8%) |
0,93 |
[0,69;1,24] |
fatal and nonfatal heart failure |
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The primary endpoint (if exists) appears in blod characters
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Reference(s) used for data extraction:
|
Endpoint |
studied treat. |
control treat. |
mean diff |
Absolute risk reduction
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Endpoint |
Events rate |
Absolute risk reduction (ARR) |
Studied treat. |
Control treat. |
Cardiovascular death |
2,54% |
2,45% |
0,9‰
|
myocardial infarction (fatal and non fatal) |
5,33% |
6,16% |
-8,2‰
|
stroke (fatal and non fatal) |
1,52% |
2,61% |
-10,9‰
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Major cardiovascular events |
8,81% |
10,00% |
-11,9‰
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All cause death |
6,35% |
6,07% |
2,8‰
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Serious adverse event |
3,26% |
1,27% |
2,0%
|
Heart failure |
3,51% |
3,80% |
-2,8‰
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Reference(s)
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Gerstein HC, Miller ME, Byington RP, Goff DC Jr, Bigger JT, Buse JB, Cushman WC, Genuth S, Ismail-Beigi F, Grimm RH Jr, Probstfield JL, Simons-Morton DG, Friedewald WT.
Effects of intensive glucose lowering in type 2 diabetes..
N Engl J Med 2008;358:2545-59
Pubmed
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Hubmed
| Fulltext
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Cushman WC, Grimm RH Jr, Cutler JA, Evans GW, Capes S, Corson MA, Sadler LS, Alderman MH, Peterson K, Bertoni A, Basile JN.
Rationale and design for the blood pressure intervention of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial..
Am J Cardiol 2007;99:44i-55i
Pubmed
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Hubmed
| Fulltext
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.
Effects of Intensive Blood-Pressure Control in Type 2 Diabetes Mellitus..
N Engl J Med 2010 Mar 14;:
Pubmed
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Hubmed
| Fulltext
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