Extreme BP, cholesterol measures unhelpful for diabetics

The research carried out by Action to Control Cardiovascular Risk in Diabetes (ACCORD) and sponsored by the U.S. government’s National Heart, Lung, and Blood Institute revealed that people with type 2 diabetes were at a higher risk of cardiovascular diseases, and rigorous blood sugar restrain attempts may heighten their risk of death.

Dr. Stephen Kopecky, cardiologist and professor of medicine, Mayo Clinic, Rochester, Minnesota said, “These results could be disappointing to a lot of people--that this intensive blood pressure control or intensive lipid control didn’t reduce fatal or nonfatal events.”

Project executive, Dr. Denise Simons-Morton, National Heart, Lung and Blood Institute said, “Doctors and patients now know that the inclination to do intensive treatment that people seemed to think would be better for cardiovascular risk reduction wasn’t better.”

10,000 patients studied
The randomized ACCORD trial studied over 10,000 type 2 diabetics with heart disease risks.

For cholesterol examination, researchers assigned fenofibrate to 5,500 type 2 diabetics with elevated heart disease risk, to their prior therapy of cholesterol-lowering drug Zocor (simvastatin).

Fenofibrate increases High-density lipoprotein (HDL) or ‘good cholesterol’ levels and reduces triglyceride levels.

In another test--ACCORD blood pressure trial, over 4,700 people with type 2 diabetes were put to a treatment to cut systolic blood pressure to below 120 mm Hg or to standard therapy designed to attain heart contraction levels of 140 mm Hg.

Results of the study
The first trial showed that the two medications made no difference in the frequency of heart related problems like stroke, heart attacks, or even death.

It was further revealed that high triglyceride levels and low HDL cholesterol levels could be beneficial for men but women were definitely at higher risk.

The second examination established that the intensive treatment altered the BP levels, but there were no variations in the occurrence of fatal or nonfatal cardiovascular actions--heart attacks and strokes.

Hence, it was established that lowering BP levels could reduce the number of stroke cases but the chances were one in 89, with critical results, that too over a treatment of five years.

Dr. David Nathan, director, diabetes center, Massachusetts General Hospital stated, “Making logical leaps to aggressively treat patients with Type 2 diabetes was ‘totally understandable’ it was also dangerous.”

The study appears in New England Journal of Medicine.