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This trial is included in the following systematic reviews and meta-analyses:

hypertension - strategy - diabetic patients  

hypertension - strategy - all type of patients  


Related trials

Cardio-Sis, 2009 - more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie

ACCORD blood pressure, 2008 - more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie

REIN-2, 2005 - more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie

AASK, 2002 - more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie

ABCD (N), 2002 - more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie

ABCD (H), 2000 - more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie

Toto, 1995 - more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie

HOT, 1994 - more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie

MDRD, 1994 - more intensive blood pressure lowering strategie vs less intensive blood pressure lowering strategie



See also:

  • All hypertension clinical trials
  • All clinical trials of strategy
  • All clinical trials of more intensive blood pressure lowering strategie
  •  

    ACCORD blood pressure study, 2008

    [NCT00000620]

    Treatments

    Studied treatment intensive therapy, targeting a systolic pressure of less than 120 mm Hg
    Control treatment standard therapy, targeting a systolic pressure of less than 140 mm Hg
    Treatments description
    Achieved systolic blood 119.3 / 133.5 mmHg 
    Achieved diastolic blood pressure 64.4 / 70.5 mmHg 

    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 

    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   
    stroke (fatal and non fatal) 36 / 2362 (1,5%) 62 / 2371 (2,6%) 0,58 [0,39;0,88]    
    Major cardiovascular events 208 / 2362 (8,8%) 237 / 2371 (10,0%) 0,88 [0,74;1,05]    
    All cause death 150 / 2362 (6,4%) 144 / 2371 (6,1%) 1,05 [0,84;1,30]    
    Serious adverse event 77 / 2362 (3,3%) 30 / 2371 (1,3%) 2,58 [1,70;3,91] attributed to blood-pressure medications   
    Heart failure 83 / 2362 (3,5%) 90 / 2371 (3,8%) 0,93 [0,69;1,24] fatal and nonfatal heart failure   
    The primary endpoint (if exists) appears in blod characters
    Reference(s) used for data extraction:

    Endpoint studied treat. control treat. mean diff

    Absolute risk reduction
    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‰
    Major cardiovascular events 8,81% 10,00% -11,9‰
    All cause death 6,35% 6,07% 2,8‰
    Serious adverse event 3,26% 1,27% 2,0%
    Heart failure 3,51% 3,80% -2,8‰


    Reference(s)

    Trials register # NCT00000620
    • 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 | Hubmed | Fulltext
    • 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 | Hubmed | Fulltext
    • . Effects of Intensive Blood-Pressure Control in Type 2 Diabetes Mellitus.. N Engl J Med 2010 Mar 14;:
      Pubmed | Hubmed | Fulltext

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