The Action to Control Cardiovascular Risk in Diabetes Blood Pressure (ACCORD BP) trial provides the strongest direct assessment of the benefits and...

The Action to Control Cardiovascular Risk in Diabetes Blood Pressure (ACCORD BP) trial provides the strongest direct assessment of the benefits and risks of intensive blood pressure control among people with type 2 diabetes (29). In ACCORD BP, compared with standard blood pressure control (target systolic blood pressure <140 mmHg), intensive blood pressure control (target systolic blood pressure <120 mmHg) did not reduce total major atherosclerotic cardiovascular events but did reduce the risk of stroke, at the expense of increased adverse events (Table 10.1). The ACCORD BP results suggest that blood pressure targets more intensive than <140/90 mmHg are not likely to improve cardiovascular outcomes among most people with type 2 diabetes but may be reasonable for patients who may derive the most benefit and have been educated about added treatment burden, side effects, and costs, as discussed below.