Aggressive Treatments Don't Help Diabetes Patients
Heart Risk Isn't Cut for Diabetes Patients Who Aggressively Lower Blood Pressure, Blood Fats
March 15, 2010 (Atlanta) -- Lowering blood pressure and blood fat levels to below current guidelines did not bring down higher risks of heart problems for diabetes patients, according to new results from a landmark federal study.
But for individual people with diabetes, the findings brought some good news in that the current standard of care worked better than expected, some doctors say. Also, for people with diabetes that are at particularly heightened risk of heart problems, aggressive management may still be needed, they point out.
Overall, the findings underscore the need for most people with diabetes to focus on healthy diets and lifestyles as well as to take the medications their doctors recommend to improve heart health, some experts tell WebMD.
The experts are reacting to results from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, launched 10 years ago to determine whether aggressively lowering blood sugar, blood pressure, and blood fat would reduce heart attacks and strokes in people with diabetes.
The new results show that lowering systolic blood pressure -- the top number -- to 120 rather than the usual recommended 140 did not lower heart attacks, strokes, or death from cardiovascular causes, reports William Cushman, MD, of the VA Medical Center in Memphis, Tenn.
Similarly, adding the fat-busting drug TriCor to standard cholesterol-lowering drugs called statins did not reduce the odds of heart attacks, strokes, or death from cardiovascular causes, says Henry Ginsberg, MD, of Columbia University in New York City. TriCor is a fibrate, designed to lower triglycerides while boosting HDL "good" cholesterol.
The studies were presented at the American College of Cardiology meeting and released simultaneously online by The New England Journal of Medicine.
A third part of the research -- about intensive lowering of blood sugar -- was prematurely halted two years ago when it turned out that the approach was associated with an increased, not decreased, risk of death.
Aggressive Therapy and Heart Risks
The blood pressure portion of ACCORD involved 4,733 people with diabetes at high risk of heart disease or stroke. They were given a variety of medications to keep their systolic blood pressure under 120 or under 140.