Tight control of blood pressure and blood fats to recommended levels is vital for heart health in people with type 2 diabetes, but going beyond these guidelines does not provide more protection, according to results from a pivotal study.
What the study proved
The Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial enrolled nearly 5,000 people with type 2 who were either likely to develop heart disease or already had it. Half the participants were assigned a systolic (top number) blood pressure goal of below 140 mm Hg while the rest were to try for less than 120 mm Hg.
After eight years, the group with lower systolic blood pressure had no less risk of heart attack, stroke, and death than the other group. In addition, all ACCORD participants took statins to lower their levels of LDL (“bad”) cholesterol.
Half of the participants added a medication called fenofibrate to reduce triglycerides and boost HDL (“good”) cholesterol.
Adding the fenofibrate helped do that, but it did not reduce participants’ risk of heart attack, stroke, and death below that in the statin-only group. The American Diabetes Association urges people not to change medications or doses without consulting a health care provider.
Source: New England Journal of Medicine, published online March 14, 2010