ACCORD: Action to Control Cardiovascular Risk in Diabetes
The ACCORD trial was a randomized, multicenter, double 2 x 2 factorial design clinical trial which tested the effects of 3 medical treatment strategies to reduce CVD morbidity and mortality in middle-aged and older white, black, asian, or Hispanic participants with type 2 diabetes mellitus who are at high risk for CVD events. All participants (n=10,251) were in the glycemia trial which tested the hypothesis that therapy targeting a HbA1c of <6% will reduce the rate of CVD events more than a target of an HbA1c of 7.0-7.0%. The study then tested two other hypotheses in the context of good glycemic control; The lipid trial tested therapy using a fibrate plus a statin versus statin plus placebo, the blood pressure trial tested the therapeutic strategy targeting a SBP <120 mm Hg compared to a target of <140 mm Hg. The primary end point for all three research questions was first occurrence to a major CVD event (nonfatal MI, nonfatal stroke, or CVD death). There are over 8,000 ACCORD participants who gave consent for genetic research and for whom DNA samples are available.
The ACCORD trial found that the more intense arm of HbA1c lowering increased mortality and did not reduce major CVD events which led to an early termination of the more intense glycemic control arm and participants were transitioned to standard therapy.
The ACCORD BP trial found no conclusive evidence that an intense BP control strategy reduced rate of CVD events.
The ACCORD lipid trial found that combination of fenofibrate and simvastatin compared to simvastatin alone did not reduce CVD events.
- John B. Buse, Principal Investigator
- Michael Wagner, University of North Carolina at Chapel Hill