Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Diabetes

Glycemic and blood-pressure control—lower is not better

The combined effect of intensive glycemic and blood-pressure control on microvascular complications has been examined in an analysis of the ACCORD study. The investigators hypothesized that simultaneous intensive management would have an additive effect on outcomes; however, the results provide no evidence to support the combined intensive control of glycemia and blood pressure.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Ismail-Beigi, F. et al. for the ACCORD Study Group. Combined intensive blood pressure and glycemic control does not produce an additive benefit on microvascular outcomes in type 2 diabetic patients. Kidney Int. http://dx.doi.org/10.1038/ki.2011.415.

  2. Rutter, M. K. & Nesto, R. W. Blood pressure, lipids and glucose in type 2 diabetes: how low should we go? Re-discovering personalized care. Eur. Heart J. 32, 2247–2255 (2011).

    Article  CAS  Google Scholar 

  3. The ACCORD Study Group. Long-term effects of intensive glucose lowering on cardiovascular outcomes. N. Engl. J. Med. 364, 818–828 (2011).

  4. The ACCORD Study Group. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N. Engl. J. Med. 362, 1575–1585 (2010).

  5. The ACCORD Study Group. Effects of combination lipid therapy in type 2 diabetes mellitus. N. Engl. J. Med. 362, 1563–1574 (2010).

  6. Mancia, G. et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J. Hypertens. 27, 2121–2158 (2009).

    Article  CAS  Google Scholar 

  7. [No authors listed] Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. BMJ 317, 703–713 (1998).

  8. de Galan, B. E. et al. on behalf of the ADVANCE Collaborative Group. Lowering blood pressure reduces renal events in type 2 diabetes. J. Am. Soc. Nephrol. 20, 883–892 (2009).

    Article  CAS  Google Scholar 

  9. The ACCORD Study Group and ACCORD Eye Study Group. Effects of medical therapies on retinopathy progression in type 2 diabetes. N. Engl. J. Med. 363, 233–244 (2010).

Download references

Author information

Authors and Affiliations

Authors

Ethics declarations

Competing interests

The author declares no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ruilope, L. Glycemic and blood-pressure control—lower is not better. Nat Rev Nephrol 8, 199–200 (2012). https://doi.org/10.1038/nrneph.2012.34

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneph.2012.34

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing