Action to Control Cardiovascular Risk in Diabetes (ACCORD)
NCT ID: NCT00000620
Last Updated: 2016-11-22
Study Results
Results available
Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.
View full resultsBasic Information
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Recruitment Status
COMPLETED
Clinical Phase
PHASE3
Total Enrollment
10251 participants
Study Classification
INTERVENTIONAL
Study Start Date
1999-09-30
Study Completion Date
2012-12-31
Brief Summary
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The purpose of this study is to prevent major cardiovascular events (heart attack, stroke, or cardiovascular death) in adults with type 2 diabetes mellitus using intensive glycemic control, intensive blood pressure control, and multiple lipid management.
Detailed Description
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BACKGROUND:
Currently, about 17 million Americans have been diagnosed with diabetes and more than 90 percent of them have type 2 diabetes. The number of people with this form of diabetes, formerly known as adult onset or non-insulin dependent diabetes, is growing rapidly. By 2050, the number of Americans with diagnosed diabetes is projected to increase by 165 percent to 29 million, of whom 27 million will have the type 2 form. Cardiovascular disease (CVD) is the leading cause of death in people with type 2 diabetes; these individuals die of CVD at rates two to four times higher than those who do not have diabetes. They also experience more nonfatal heart attacks and strokes.
Type 2 diabetes is associated with older age and is more common in those who are overweight or obese and have a family history of diabetes. Women with a history of diabetes during pregnancy, adults with impaired glucose tolerance, people with a sedentary lifestyle, and members of a minority race/ethnicity are also at a greater risk for developing type 2 diabetes. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes.
DESIGN NARRATIVE:
The three strategies tested in ACCORD included the following: (1) Blood sugar - ACCORD was designed to determine whether lowering blood glucose to a level closer to normal than called for in current guidelines reduces CVD risk. The study estimated effects on CVD of that level compared with a level that is usually targeted. (2) Blood pressure - many people with type 2 diabetes have high blood pressure. The blood pressure part of the trial was designed to determine the effects of lowering blood pressure in the context of good blood sugar control, that is to determine whether lowering blood pressure to normal (systolic pressure less than 120 mm Hg) will better reduce CVD risk, as compared to a usually-targeted level in current clinical practice (i.e., below the definition of hypertension; systolic pressure less than 140 mm Hg). (3) Blood Fats - Many people with diabetes have high levels of LDL ("bad") cholesterol and triglycerides, as well as low levels of HDL ("good") cholesterol. ACCORD participants who are selected for this part of the trial were assigned to an intervention to improve blood fat levels. This part of the study looked at the effects of lowering LDL cholesterol and blood triglycerides and increasing HDL cholesterol compared to an intervention that only lowers LDL cholesterol, all in the context of good blood sugar control. A drug from a class of drugs called "fibrates" was used to lower triglycerides and increase HDL cholesterol, whereas a drug from the class of drugs called "statins" was used to lower LDL cholesterol.
All ACCORD participants received blood sugar treatment from the study. Based on the second trial (Blood Pressure or Lipid) they were assigned to, participants also received their high blood pressure or cholesterol care from the study. Study participants received all medication and treatments related to the study free of charge. Individuals who selected for and consented to participate in the ACCORD study continued to see their personal physician for all other health care.
In summary, the ACCORD Study was a double 2x2 factorial design with factors consisting of: intensive versus standard glycemic control, intensive versus standard blood pressure control, and blinded fenofibrate or placebo in combination with simvastatin to maintain desirable LDL-C levels. All 10,251 participants were randomized to the glycemic interventions; a subgroup of 4,733 participants who met the blood pressure entry criteria were randomized to the blood pressure interventions in one 2x2 trial; and a distinct subgroup of 5,518 participants who met the lipid entry criteria were randomized to the lipid interventions in the second 2x2 trial. All participants had established type 2 diabetes and were recruited from 77 clinical centers in the United States (64 sites) and Canada (13 sites).
On February 6, 2008, the National Heart, Lung and Blood Institute (NHLBI) announced that participants in the intensive glycemia treatment would be transitioned to the ACCORD standard glycemic treatment approach due to higher mortality in the intensive treatment group terminating the experimental arm of the Glycemia Trial early. The Blood Pressure and Lipid trials continued as designed to their planned termination in 2009.
Currently, about 17 million Americans have been diagnosed with diabetes and more than 90 percent of them have type 2 diabetes. The number of people with this form of diabetes, formerly known as adult onset or non-insulin dependent diabetes, is growing rapidly. By 2050, the number of Americans with diagnosed diabetes is projected to increase by 165 percent to 29 million, of whom 27 million will have the type 2 form. Cardiovascular disease (CVD) is the leading cause of death in people with type 2 diabetes; these individuals die of CVD at rates two to four times higher than those who do not have diabetes. They also experience more nonfatal heart attacks and strokes.
Type 2 diabetes is associated with older age and is more common in those who are overweight or obese and have a family history of diabetes. Women with a history of diabetes during pregnancy, adults with impaired glucose tolerance, people with a sedentary lifestyle, and members of a minority race/ethnicity are also at a greater risk for developing type 2 diabetes. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes.
DESIGN NARRATIVE:
The three strategies tested in ACCORD included the following: (1) Blood sugar - ACCORD was designed to determine whether lowering blood glucose to a level closer to normal than called for in current guidelines reduces CVD risk. The study estimated effects on CVD of that level compared with a level that is usually targeted. (2) Blood pressure - many people with type 2 diabetes have high blood pressure. The blood pressure part of the trial was designed to determine the effects of lowering blood pressure in the context of good blood sugar control, that is to determine whether lowering blood pressure to normal (systolic pressure less than 120 mm Hg) will better reduce CVD risk, as compared to a usually-targeted level in current clinical practice (i.e., below the definition of hypertension; systolic pressure less than 140 mm Hg). (3) Blood Fats - Many people with diabetes have high levels of LDL ("bad") cholesterol and triglycerides, as well as low levels of HDL ("good") cholesterol. ACCORD participants who are selected for this part of the trial were assigned to an intervention to improve blood fat levels. This part of the study looked at the effects of lowering LDL cholesterol and blood triglycerides and increasing HDL cholesterol compared to an intervention that only lowers LDL cholesterol, all in the context of good blood sugar control. A drug from a class of drugs called "fibrates" was used to lower triglycerides and increase HDL cholesterol, whereas a drug from the class of drugs called "statins" was used to lower LDL cholesterol.
All ACCORD participants received blood sugar treatment from the study. Based on the second trial (Blood Pressure or Lipid) they were assigned to, participants also received their high blood pressure or cholesterol care from the study. Study participants received all medication and treatments related to the study free of charge. Individuals who selected for and consented to participate in the ACCORD study continued to see their personal physician for all other health care.
In summary, the ACCORD Study was a double 2x2 factorial design with factors consisting of: intensive versus standard glycemic control, intensive versus standard blood pressure control, and blinded fenofibrate or placebo in combination with simvastatin to maintain desirable LDL-C levels. All 10,251 participants were randomized to the glycemic interventions; a subgroup of 4,733 participants who met the blood pressure entry criteria were randomized to the blood pressure interventions in one 2x2 trial; and a distinct subgroup of 5,518 participants who met the lipid entry criteria were randomized to the lipid interventions in the second 2x2 trial. All participants had established type 2 diabetes and were recruited from 77 clinical centers in the United States (64 sites) and Canada (13 sites).
On February 6, 2008, the National Heart, Lung and Blood Institute (NHLBI) announced that participants in the intensive glycemia treatment would be transitioned to the ACCORD standard glycemic treatment approach due to higher mortality in the intensive treatment group terminating the experimental arm of the Glycemia Trial early. The Blood Pressure and Lipid trials continued as designed to their planned termination in 2009.
Conditions
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Atherosclerosis
Cardiovascular Diseases
Hypercholesterolemia
Hypertension
Diabetes Mellitus, Type 2
Diabetes Mellitus
Coronary Disease
Keywords
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Diabetes Mellitus, Non-Insulin-Dependent
Study Design
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Allocation Method
RANDOMIZED
Intervention Model
FACTORIAL
Primary Study Purpose
PREVENTION
Blinding Strategy
NONE
Study Groups
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Glycemia Trial: intensive control
Open label administration of oral anti-hyperglycemic agents and/or insulin in combination with dietary/lifestyle advice as needed to achieve glycated hemoglobin (HbA1c) levels \<6.0%.
Group Type
EXPERIMENTAL
Anti-hyperglycemic Agents
Intervention Type
DRUG
Multiple drugs including insulins and oral anti-hyperglycemic agents as needed to reach Glycemia Trial arm-specific goals (intensive control \<6%; standard control 7.0-7.9%).
Glycemia Trial: standard control
Open label administration of oral anti-hyperglycemic agents and/or insulin in combination with dietary/lifestyle advice as needed to achieve glycated hemoglobin (HbA1c) levels of 7.0 - 7.9%.
Group Type
ACTIVE_COMPARATOR
Anti-hyperglycemic Agents
Intervention Type
DRUG
Multiple drugs including insulins and oral anti-hyperglycemic agents as needed to reach Glycemia Trial arm-specific goals (intensive control \<6%; standard control 7.0-7.9%).
BP Trial: intensive control
Open label administration of anti-hypertensive agents to reduce and maintain systolic blood pressure (SBP) level to \<120 mmHg.
Group Type
EXPERIMENTAL
Anti-hypertensive Agents
Intervention Type
DRUG
Multiple anti-hypertensive agents as needed to reach Blood Pressure Trial arm-specific goals (intensive control \<120 mm Hg; standard control \<140 mm Hg).
BP Trial: standard control
Open label administration of multiple anti-hypertensive agents to maintain SBP level \<140 mm Hg.
Group Type
ACTIVE_COMPARATOR
Anti-hypertensive Agents
Intervention Type
DRUG
Multiple anti-hypertensive agents as needed to reach Blood Pressure Trial arm-specific goals (intensive control \<120 mm Hg; standard control \<140 mm Hg).
Lipid Trial: fenofibrate
Double blind administration of 160 mg/day of fenofibrate in participants with estimated glomerular filtration rate (eGFR) ≥50 mL/min/1.73m2 or 54 mg/day in patients with eGFR \<50 mL/min/1.73m2 in combination with open label simvastatin.
Group Type
EXPERIMENTAL
Blinded fenofibrate or placebo plus simvastatin
Intervention Type
DRUG
Double blind administration of 160 mg/day of fenofibrate in participants with estimated glomerular filtration rate (eGFR) ≥50 mL/min/1.73m2 or 54 mg/day in patients with eGFR \<50 mL/min/1.73m2 or matching placebo in combination with open label simvastatin 20 - 40 mg/day.
Lipid Trial: placebo
Double blind administration of placebo matching either 160 mg/day in participants with eGFR ≥50 mL/min/1.73m2 or 54 mg/day in participants with eGFR \<50 mL/min/1.73m2 in combination with open label simvastatin.
Group Type
PLACEBO_COMPARATOR
Blinded fenofibrate or placebo plus simvastatin
Intervention Type
DRUG
Double blind administration of 160 mg/day of fenofibrate in participants with estimated glomerular filtration rate (eGFR) ≥50 mL/min/1.73m2 or 54 mg/day in patients with eGFR \<50 mL/min/1.73m2 or matching placebo in combination with open label simvastatin 20 - 40 mg/day.
Interventions
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Anti-hyperglycemic Agents
Multiple drugs including insulins and oral anti-hyperglycemic agents as needed to reach Glycemia Trial arm-specific goals (intensive control \<6%; standard control 7.0-7.9%).
Intervention Type
DRUG
Anti-hypertensive Agents
Multiple anti-hypertensive agents as needed to reach Blood Pressure Trial arm-specific goals (intensive control \<120 mm Hg; standard control \<140 mm Hg).
Intervention Type
DRUG
Blinded fenofibrate or placebo plus simvastatin
Double blind administration of 160 mg/day of fenofibrate in participants with estimated glomerular filtration rate (eGFR) ≥50 mL/min/1.73m2 or 54 mg/day in patients with eGFR \<50 mL/min/1.73m2 or matching placebo in combination with open label simvastatin 20 - 40 mg/day.
Intervention Type
DRUG
Other Intervention Names
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glimepiride (Amaryl)
metformin (Glucophage)
repaglinide (Gluconorm, Prandin)
rosiglitazone (Avandia)
pioglitazone (Actos)
human regular insulin (Novolin ge Toronto)
human NPH (Novolin N)
human mixed (Novolin 70/30)
human isophane (Novolin ge NPH)
human 30/70 (Novolin ge 30/70)
insulin aspart (NovoRapid, NovoLog)
insulin detemir (Levemir)
human regular insulin (Novolin R)
insulin glargine (Lantus)
Acarbose
benazepril (Lotensin, Zestril, Altace)
chlorthalidone (Thalitone)
metoprolol (Toprol XL)
diltiazem (Tiazac)
plendil (Felodipine)
terazosin (Hytrin)
candesartan (Atacand)
valsartan (Diovan)
furosemide
reserpine
hydralazine
carvedilol (Coreg)
triamterene / hydrochlorothiazide (Dyazide)
metoprolol / hydrochlorothiazide(Lopressor HCT)
benazepril / hydrochlorothiazide (Lotensin HCT)
lisinopril / hydrochlorothiazide (Zestoretic)
candesartan / hydrochlorothiazide (Atacand HCT)
valsartan / hydrochlorothiazide (Diovan HCT)
amlodipine / benazepril (Lotrel)
fenofibrate (Tricor)
Eligibility Criteria
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Inclusion Criteria
* Diagnosed with type 2 diabetes mellitus, as determined by the new American Diabetes Association guidelines, which include a fasting plasma glucose level greater than 126 mg/dl (7.0 mmol/l), or a 2-hour postload value in the oral glucose tolerance test of greater than 200 mg/dl, with confirmation by a retest
* For participants aged 40 years or older, history of CVD (heart attack, stroke, history of coronary revascularization, history of peripheral or carotid revascularization, or demonstrated angina)
* For participants aged 55 years or older, a history of CVD is not required, but participant must be considered to be at high risk for experiencing a CVD event due to existing CVD, subclinical disease, or 2+ CVD risk factors
* HbA1c 7.5%-9% (if on more drugs) or 7.5%-11% (if on fewer drugs)
* For participants aged 40 years or older, history of CVD (heart attack, stroke, history of coronary revascularization, history of peripheral or carotid revascularization, or demonstrated angina)
* For participants aged 55 years or older, a history of CVD is not required, but participant must be considered to be at high risk for experiencing a CVD event due to existing CVD, subclinical disease, or 2+ CVD risk factors
* HbA1c 7.5%-9% (if on more drugs) or 7.5%-11% (if on fewer drugs)
Minimum Eligible Age
40 Years
Maximum Eligible Age
79 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
No
Sponsors
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
NIH
Sponsor Role
collaborator
National Institute on Aging (NIA)
NIH
Sponsor Role
collaborator
National Eye Institute (NEI)
NIH
Sponsor Role
collaborator
Centers for Disease Control and Prevention
FED
Sponsor Role
collaborator
National Heart, Lung, and Blood Institute (NHLBI)
NIH
Sponsor Role
lead
Responsible Party
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Responsibility Role
SPONSOR
Principal Investigators
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Denise Simons-Morton, MD, PhD
Role: STUDY_DIRECTOR
National Heart, Lung, and Blood Institute (NHLBI)
William Friedewald, MD
Role: STUDY_CHAIR
Columbia University, New York, NY
Robert Byington, PhD
Role: PRINCIPAL_INVESTIGATOR
Wake Forest University, Winston-Salem, NC
Locations
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Minneapolis Medical Research Foundation
Minneapolis, Minnesota, United States
Site Status
Columbia University
New York, New York, United States
Site Status
Wake Forest University
Winston-Salem, North Carolina, United States
Site Status
Case Western Reserve University
Cleveland, Ohio, United States
Site Status
Veterans Affairs
Memphis, Tennessee, United States
Site Status
University of Washington
Seattle, Washington, United States
Site Status
McMaster University
Hamilton, Ontario, Canada
Site Status
Countries
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United States
Canada
References
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Cushman WC, Grimm RH Jr, Cutler JA, Evans GW, Capes S, Corson MA, Sadler LS, Alderman MH, Peterson K, Bertoni A, Basile JN; ACCORD Study Group. Rationale and design for the blood pressure intervention of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Am J Cardiol. 2007 Jun 18;99(12A):44i-55i. doi: 10.1016/j.amjcard.2007.03.005. Epub 2007 Apr 16.
Reference Type
BACKGROUND
Williamson JD, Miller ME, Bryan RN, Lazar RM, Coker LH, Johnson J, Cukierman T, Horowitz KR, Murray A, Launer LJ; ACCORD Study Group. The Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes Study (ACCORD-MIND): rationale, design, and methods. Am J Cardiol. 2007 Jun 18;99(12A):112i-122i. doi: 10.1016/j.amjcard.2007.03.029. Epub 2007 Apr 12.
Reference Type
BACKGROUND
Sullivan MD, Anderson RT, Aron D, Atkinson HH, Bastien A, Chen GJ, Feeney P, Gafni A, Hwang W, Katz LA, Narayan KM, Nwachuku C, O'Connor PJ, Zhang P; ACCORD Study Group. Health-related quality of life and cost-effectiveness components of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial: rationale and design. Am J Cardiol. 2007 Jun 18;99(12A):90i-102i. doi: 10.1016/j.amjcard.2007.03.027. Epub 2007 Apr 13.
Reference Type
BACKGROUND
Bonds DE, Kurashige EM, Bergenstal R, Brillon D, Domanski M, Felicetta JV, Fonseca VA, Hall K, Hramiak I, Miller ME, Osei K, Simons-Morton DG; ACCORD Study Group. Severe hypoglycemia monitoring and risk management procedures in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Am J Cardiol. 2007 Jun 18;99(12A):80i-89i. doi: 10.1016/j.amjcard.2007.03.026. Epub 2007 Apr 17.
Reference Type
BACKGROUND
Kingry C, Bastien A, Booth G, Geraci TS, Kirpach BR, Lovato LC, Margolis KL, Rosenberg Y, Sperl-Hillen JM, Vargo L, Williamson JD, Probstfield JL; ACCORD Study Group. Recruitment strategies in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Am J Cardiol. 2007 Jun 18;99(12A):68i-79i. doi: 10.1016/j.amjcard.2007.03.025. Epub 2007 Apr 12.
Reference Type
BACKGROUND
Ginsberg HN, Bonds DE, Lovato LC, Crouse JR, Elam MB, Linz PE, O'connor PJ, Leiter LA, Weiss D, Lipkin E, Fleg JL; ACCORD Study Group. Evolution of the lipid trial protocol of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Am J Cardiol. 2007 Jun 18;99(12A):56i-67i. doi: 10.1016/j.amjcard.2007.03.024. Epub 2007 Apr 12.
Reference Type
BACKGROUND
Goff DC Jr, Gerstein HC, Ginsberg HN, Cushman WC, Margolis KL, Byington RP, Buse JB, Genuth S, Probstfield JL, Simons-Morton DG; ACCORD Study Group. Prevention of cardiovascular disease in persons with type 2 diabetes mellitus: current knowledge and rationale for the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Am J Cardiol. 2007 Jun 18;99(12A):4i-20i. doi: 10.1016/j.amjcard.2007.03.002. Epub 2007 Apr 12.
Reference Type
BACKGROUND
Gerstein HC, Riddle MC, Kendall DM, Cohen RM, Goland R, Feinglos MN, Kirk JK, Hamilton BP, Ismail-Beigi F, Feeney P; ACCORD Study Group. Glycemia treatment strategies in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Am J Cardiol. 2007 Jun 18;99(12A):34i-43i. doi: 10.1016/j.amjcard.2007.03.004. Epub 2007 Apr 19.
Reference Type
BACKGROUND
ACCORD Study Group; Buse JB, Bigger JT, Byington RP, Cooper LS, Cushman WC, Friedewald WT, Genuth S, Gerstein HC, Ginsberg HN, Goff DC Jr, Grimm RH Jr, Margolis KL, Probstfield JL, Simons-Morton DG, Sullivan MD. Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial: design and methods. Am J Cardiol. 2007 Jun 18;99(12A):21i-33i. doi: 10.1016/j.amjcard.2007.03.003. Epub 2007 Apr 16.
Reference Type
BACKGROUND
Chew EY, Ambrosius WT, Howard LT, Greven CM, Johnson S, Danis RP, Davis MD, Genuth S, Domanski M; ACCORD Study Group. Rationale, design, and methods of the Action to Control Cardiovascular Risk in Diabetes Eye Study (ACCORD-EYE). Am J Cardiol. 2007 Jun 18;99(12A):103i-111i. doi: 10.1016/j.amjcard.2007.03.028. Epub 2007 Apr 13.
Reference Type
BACKGROUND
Action to Control Cardiovascular Risk in Diabetes Study Group; Gerstein HC, Miller ME, Byington RP, Goff DC Jr, Bigger JT, Buse JB, Cushman WC, Genuth S, Ismail-Beigi F, Grimm RH Jr, Probstfield JL, Simons-Morton DG, Friedewald WT. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008 Jun 12;358(24):2545-59. doi: 10.1056/NEJMoa0802743. Epub 2008 Jun 6.
Reference Type
RESULT
Sano Y, Jin R, Yoshioka H, Nakazato Y, Sato H, Hisaka A. Development of a Novel Machine Learning Method for Estimation of Life-Long Chronic Disease Progression and Its Application to Type 2 Diabetes. Clin Transl Sci. 2025 Oct;18(10):e70351. doi: 10.1111/cts.70351.
Reference Type
DERIVED
Wang J, Lv W, Wang Z, Li S, Wang Z, Zhou L, Wang Y, Ren L, Jiang C, He L, Xia S, Kong X, Zuo S, Kong Y, Guo X, Liu X, Li S, Tang R, Long D, Sang C, Zhou N, Du X, Dong J, Ma C. Orthostatic Systolic Blood Pressure Elevation and Incident Atrial Fibrillation: Insights From the SPRINT Trial. J Clin Hypertens (Greenwich). 2025 Aug;27(8):e70122. doi: 10.1111/jch.70122.
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DERIVED
Wang Z, Wang J, He L, Jiang C, Wang Y, Shen T, Zhao M, Li E, Zhou N, Sang C, Du X, Dong J, Ma C. Intensive Blood Pressure Control in Patients With Diabetes and Previous Stroke: A Post-Hoc Analysis of ACCORD-BP Trial. J Clin Hypertens (Greenwich). 2025 Jul;27(7):e70095. doi: 10.1111/jch.70095.
Reference Type
DERIVED
Liu M, Pei J, Zeng C, Xin Y, Tang P, Hu X. Association and predictive value of the triglyceride glucose-weight adjusted waist index for cardiovascular outcomes in patients with type 2 diabetes. Sci Rep. 2025 Jul 8;15(1):24573. doi: 10.1038/s41598-025-08580-4.
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Yang Y, Xing Z. Depressive Symptoms and Metabolic Dysregulation Control: A Closer Look at Control Challenges in T2DM Patients. Depress Anxiety. 2024 Sep 27;2024:7115559. doi: 10.1155/2024/7115559. eCollection 2024.
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Cheng Y, Zhu XB, Xu YL, Zou J, Huang W, Tian J, Sheng CS. Time in target range of systolic blood pressure and eGFR slope in patients with type 2 diabetes. Hypertens Res. 2025 May;48(5):1787-1798. doi: 10.1038/s41440-025-02173-4. Epub 2025 Mar 10.
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DERIVED
Li S, Lin L, Chen X, Liu S, Gao M, Cheng X, Li C. Association between body fat variation rate and risk of diabetic nephropathy - a posthoc analysis based on ACCORD database. BMC Public Health. 2024 Oct 14;24(1):2805. doi: 10.1186/s12889-024-20317-y.
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Zhang W, Huang Y, Zhou Z, Xie P, Zhuang X, Jiang J, Liao X. Cardiac autonomic neuropathy modified the association between obesity and hypoglycemia in type 2 diabetes. Endocrine. 2024 Sep;85(3):1213-1221. doi: 10.1007/s12020-024-03728-0. Epub 2024 Jun 21.
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Yang R, Jiang H, Xing Z, Ding H, Yin Z, Fu L, Tai S. Cumulative blood pressure predicts risk of stroke in individuals with type 2 diabetes. Diabetes Metab Syndr. 2024 Mar;18(3):102988. doi: 10.1016/j.dsx.2024.102988. Epub 2024 Mar 15.
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Zhou Y, Chai X, Yang G, Sun X, Xing Z. Changes in body mass index and waist circumference and heart failure in type 2 diabetes mellitus. Front Endocrinol (Lausanne). 2023 Dec 21;14:1305839. doi: 10.3389/fendo.2023.1305839. eCollection 2023.
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Cromer SJ, Thaweethai T, Wexler DJ. Racial/ethnic and socioeconomic disparities in achievement of treatment goals within a clinical trial: a secondary analysis of the ACCORD trial. Diabetologia. 2023 Dec;66(12):2261-2274. doi: 10.1007/s00125-023-05997-2. Epub 2023 Sep 16.
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King JB, Berchie RO, Derington CG, Marcum ZA, Scharfstein DO, Greene TH, Herrick JS, Jacobs JA, Zheutlin AR, Bress AP, Cohen JB. New Users of Angiotensin II Receptor Blocker-Versus Angiotensin-Converting Enzyme Inhibitor-Based Antihypertensive Medication Regimens and Cardiovascular Disease Events: A Secondary Analysis of ACCORD-BP and SPRINT. J Am Heart Assoc. 2023 Sep 5;12(17):e030311. doi: 10.1161/JAHA.123.030311. Epub 2023 Aug 30.
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Kloecker DE, Davies MJ, Pitocco D, Khunti K, Zaccardi F. Intensive glucose control and recurrent cardiovascular events: 14-year follow-up investigation of the ACCORDION study. Diabetes Metab Res Rev. 2023 Jul;39(5):e3634. doi: 10.1002/dmrr.3634. Epub 2023 Apr 4.
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Zhou C, Zhang Y, Yang S, He P, Wu Q, Ye Z, Liu M, Zhang Y, Li R, Liu C, Jiang J, Hou FF, Nie J, Qin X. Associations between visceral adiposity index and incident nephropathy outcomes in diabetic patients: Insights from the ACCORD trial. Diabetes Metab Res Rev. 2023 Mar;39(3):e3602. doi: 10.1002/dmrr.3602. Epub 2022 Dec 30.
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Tang X, Zhu Y, Xing Z. Predicted lean body mass, fat mass, and heart failure in patients with type 2 diabetes mellitus. Am Heart J. 2023 Mar;257:78-84. doi: 10.1016/j.ahj.2022.12.008. Epub 2022 Dec 14.
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Saiz LC, Gorricho J, Garjon J, Celaya MC, Erviti J, Leache L. Blood pressure targets for the treatment of people with hypertension and cardiovascular disease. Cochrane Database Syst Rev. 2022 Nov 18;11(11):CD010315. doi: 10.1002/14651858.CD010315.pub5.
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Xing Z, Long C, Hu X, Chai X. Obesity is associated with greater cognitive function in patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne). 2022 Oct 24;13:953826. doi: 10.3389/fendo.2022.953826. eCollection 2022.
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Long C, Tang Y, Huang J, Liu S, Xing Z. Association of long-term visit-to-visit variability of HbA1c and fasting glycemia with hypoglycemia in type 2 diabetes mellitus. Front Endocrinol (Lausanne). 2022 Aug 11;13:975468. doi: 10.3389/fendo.2022.975468. eCollection 2022.
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Tai S, Fu L, Zhang N, Yang R, Zhou Y, Xing Z, Wang Y, Zhou S. Association of the cumulative triglyceride-glucose index with major adverse cardiovascular events in patients with type 2 diabetes. Cardiovasc Diabetol. 2022 Aug 23;21(1):161. doi: 10.1186/s12933-022-01599-1.
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Fu L, Tai S, Sun J, Zhang N, Zhou Y, Xing Z, Wang Y, Zhou S. Remnant Cholesterol and Its Visit-to-Visit Variability Predict Cardiovascular Outcomes in Patients With Type 2 Diabetes: Findings From the ACCORD Cohort. Diabetes Care. 2022 Sep 1;45(9):2136-2143. doi: 10.2337/dc21-2511.
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Hukportie DN, Li FR, Zhou R, Zheng JZ, Wu XX, Zou MC, Wu XB. Lipid variability and risk of microvascular complications in Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial: A post hoc analysis. J Diabetes. 2022 Jun;14(6):365-376. doi: 10.1111/1753-0407.13273. Epub 2022 Jun 6.
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Launer LJ, Miller ME, Williamson JD, Lazar RM, Gerstein HC, Murray AM, Sullivan M, Horowitz KR, Ding J, Marcovina S, Lovato LC, Lovato J, Margolis KL, O'Connor P, Lipkin EW, Hirsch J, Coker L, Maldjian J, Sunshine JL, Truwit C, Davatzikos C, Bryan RN; ACCORD MIND investigators. Effects of intensive glucose lowering on brain structure and function in people with type 2 diabetes (ACCORD MIND): a randomised open-label substudy. Lancet Neurol. 2011 Nov;10(11):969-77. doi: 10.1016/S1474-4422(11)70188-0. Epub 2011 Sep 28.
Reference Type
DERIVED
Mychaleckyj JC, Farber EA, Chmielewski J, Artale J, Light LS, Bowden DW, Hou X, Marcovina SM. Buffy coat specimens remain viable as a DNA source for highly multiplexed genome-wide genetic tests after long term storage. J Transl Med. 2011 Jun 10;9:91. doi: 10.1186/1479-5876-9-91.
Reference Type
DERIVED
ACCORD Study Group; Gerstein HC, Miller ME, Genuth S, Ismail-Beigi F, Buse JB, Goff DC Jr, Probstfield JL, Cushman WC, Ginsberg HN, Bigger JT, Grimm RH Jr, Byington RP, Rosenberg YD, Friedewald WT. Long-term effects of intensive glucose lowering on cardiovascular outcomes. N Engl J Med. 2011 Mar 3;364(9):818-28. doi: 10.1056/NEJMoa1006524.
Reference Type
DERIVED
Ismail-Beigi F, Craven T, Banerji MA, Basile J, Calles J, Cohen RM, Cuddihy R, Cushman WC, Genuth S, Grimm RH Jr, Hamilton BP, Hoogwerf B, Karl D, Katz L, Krikorian A, O'Connor P, Pop-Busui R, Schubart U, Simmons D, Taylor H, Thomas A, Weiss D, Hramiak I; ACCORD trial group. Effect of intensive treatment of hyperglycaemia on microvascular outcomes in type 2 diabetes: an analysis of the ACCORD randomised trial. Lancet. 2010 Aug 7;376(9739):419-30. doi: 10.1016/S0140-6736(10)60576-4. Epub 2010 Jun 30.
Reference Type
DERIVED
ACCORD Study Group; ACCORD Eye Study Group; Chew EY, Ambrosius WT, Davis MD, Danis RP, Gangaputra S, Greven CM, Hubbard L, Esser BA, Lovato JF, Perdue LH, Goff DC Jr, Cushman WC, Ginsberg HN, Elam MB, Genuth S, Gerstein HC, Schubart U, Fine LJ. Effects of medical therapies on retinopathy progression in type 2 diabetes. N Engl J Med. 2010 Jul 15;363(3):233-44. doi: 10.1056/NEJMoa1001288. Epub 2010 Jun 29.
Reference Type
DERIVED
Strylewicz G, Doctor J. Evaluation of an automated method to assist with error detection in the ACCORD central laboratory. Clin Trials. 2010 Aug;7(4):380-9. doi: 10.1177/1740774510372779. Epub 2010 Jun 22.
Reference Type
DERIVED
Riddle MC, Ambrosius WT, Brillon DJ, Buse JB, Byington RP, Cohen RM, Goff DC Jr, Malozowski S, Margolis KL, Probstfield JL, Schnall A, Seaquist ER; Action to Control Cardiovascular Risk in Diabetes Investigators. Epidemiologic relationships between A1C and all-cause mortality during a median 3.4-year follow-up of glycemic treatment in the ACCORD trial. Diabetes Care. 2010 May;33(5):983-90. doi: 10.2337/dc09-1278.
Reference Type
DERIVED
ACCORD Study Group; Ginsberg HN, Elam MB, Lovato LC, Crouse JR 3rd, Leiter LA, Linz P, Friedewald WT, Buse JB, Gerstein HC, Probstfield J, Grimm RH, Ismail-Beigi F, Bigger JT, Goff DC Jr, Cushman WC, Simons-Morton DG, Byington RP. Effects of combination lipid therapy in type 2 diabetes mellitus. N Engl J Med. 2010 Apr 29;362(17):1563-74. doi: 10.1056/NEJMoa1001282. Epub 2010 Mar 14.
Reference Type
DERIVED
ACCORD Study Group; Cushman WC, Evans GW, Byington RP, Goff DC Jr, Grimm RH Jr, Cutler JA, Simons-Morton DG, Basile JN, Corson MA, Probstfield JL, Katz L, Peterson KA, Friedewald WT, Buse JB, Bigger JT, Gerstein HC, Ismail-Beigi F. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med. 2010 Apr 29;362(17):1575-85. doi: 10.1056/NEJMoa1001286. Epub 2010 Mar 14.
Reference Type
DERIVED
Pop-Busui R, Evans GW, Gerstein HC, Fonseca V, Fleg JL, Hoogwerf BJ, Genuth S, Grimm RH, Corson MA, Prineas R; Action to Control Cardiovascular Risk in Diabetes Study Group. Effects of cardiac autonomic dysfunction on mortality risk in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Diabetes Care. 2010 Jul;33(7):1578-84. doi: 10.2337/dc10-0125. Epub 2010 Mar 9.
Reference Type
DERIVED
Miller ME, Bonds DE, Gerstein HC, Seaquist ER, Bergenstal RM, Calles-Escandon J, Childress RD, Craven TE, Cuddihy RM, Dailey G, Feinglos MN, Ismail-Beigi F, Largay JF, O'Connor PJ, Paul T, Savage PJ, Schubart UK, Sood A, Genuth S; ACCORD Investigators. The effects of baseline characteristics, glycaemia treatment approach, and glycated haemoglobin concentration on the risk of severe hypoglycaemia: post hoc epidemiological analysis of the ACCORD study. BMJ. 2010 Jan 8;340:b5444. doi: 10.1136/bmj.b5444.
Reference Type
DERIVED
Bonds DE, Miller ME, Bergenstal RM, Buse JB, Byington RP, Cutler JA, Dudl RJ, Ismail-Beigi F, Kimel AR, Hoogwerf B, Horowitz KR, Savage PJ, Seaquist ER, Simmons DL, Sivitz WI, Speril-Hillen JM, Sweeney ME. The association between symptomatic, severe hypoglycaemia and mortality in type 2 diabetes: retrospective epidemiological analysis of the ACCORD study. BMJ. 2010 Jan 8;340:b4909. doi: 10.1136/bmj.b4909.
Reference Type
DERIVED
Meier M, Hummel M. Cardiovascular disease and intensive glucose control in type 2 diabetes mellitus: moving practice toward evidence-based strategies. Vasc Health Risk Manag. 2009;5:859-71. doi: 10.2147/vhrm.s4808. Epub 2009 Nov 2.
Reference Type
DERIVED
Study Documents
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Document Type: Individual Participant Data Set
View DocumentDocument Type: Study Protocol
View DocumentDocument Type: Study Forms
View DocumentDocument Type: Manual of Procedures
View DocumentRelated Links
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http://www.accordtrial.org/
Click here for the ACCORD trial web site
Other Identifiers
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IAA#Y1HC9035
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
IAA#Y1HC1010
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
123
Identifier Type: -
Identifier Source: org_study_id
NCT00182910
Identifier Type: -
Identifier Source: nct_alias