Combined lipid therapy, intensive blood pressure control not found to reduce cardiac events
MONDAY, March 15 (HealthDay News) -- In type 2 diabetes patients at high risk for cardiovascular events, combination lipid therapy with fenofibrate and simvastatin does not reduce the rate of cardiovascular events compared with simvastatin alone, and intensive blood pressure control, compared to standard blood pressure control, also does not reduce the rate of adverse cardiovascular events, according to the results of two analyses of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study. The findings were published online March 14 in the New England Journal of Medicine to coincide with the Annual Scientific Session of the American College of Cardiology, held from March 14 to 16 in Atlanta.
According to Harry N. Ginsberg, M.D., of the Columbia University College of Physicians and Surgeons in New York City, and colleagues, the ACCORD study group randomized 5,518 type 2 diabetes patients who were being treated with open-label simvastatin to receive either fenofibrate or placebo. Compared to simvastatin monotherapy, the combination of fenofibrate and simvastatin did not reduce rates of adverse cardiovascular events, including death from cardiovascular causes, nonfatal stroke, or nonfatal myocardial infarction.
According to William C. Cushman, M.D., of the Veterans Affairs Medical Center in Memphis, Tenn., and colleagues, the ACCORD study group also evaluated intensive blood pressure control by randomizing 4,733 type 2 diabetes patients to intensive blood pressure control (targeting a systolic blood pressure of less than 120 mm Hg) or standard blood pressure control (targeting a systolic blood pressure of less than 140 mm Hg). The researchers found that intensive blood pressure control, as compared to standard blood pressure control, did not reduce the rate of a composite outcome of death from cardiovascular events, nonfatal stroke, or nonfatal myocardial infarction.
"Intensive antihypertensive therapy in the ACCORD blood pressure trial did not significantly reduce the primary cardiovascular outcome or the rate of death from any cause, despite the fact that there was a significant and sustained difference between the intensive-therapy group and the standard-therapy group in mean systolic blood pressure," Cushman and colleagues write.
Multiple pharmaceutical companies provided study medication, equipment or supplies for the ACCORD study; several study authors reported financial relationships with these companies.
Abstract - Ginsberg
Abstract - Cushman