Aggressive Treatments Don't Help Diabetes Patients
Heart Risk Isn't Cut for Diabetes Patients Who Aggressively Lower Blood Pressure, Blood Fats
WebMD News Archive
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
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"
The studies were presented at the American College of Cardiology meeting and
released simultaneously online by The New England Journal of
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.