Journal article
Systolic Blood Pressure Control Among Individuals With Type 2 Diabetes: A Comparative Effectiveness Analysis of Three Interventions
American journal of hypertension, Vol.28(8), pp.995-1009
08/2015
DOI: 10.1093/ajh/hpu292
PMCID: PMC4506323
PMID: 25666468
Abstract
The relative effectiveness of 3 approaches to blood pressure control-(i) an intensive lifestyle intervention (ILI) focused on weight loss, (ii) frequent goal-based monitoring of blood pressure with pharmacological management, and (iii) education and support-has not been established among overweight and obese adults with type 2 diabetes who are appropriate for each intervention.
Participants from the Action for Health in Diabetes (Look AHEAD) and the Action to Control Cardiovascular Risk in Diabetes (ACCORD) cohorts who met criteria for both clinical trials were identified. The proportions of these individuals with systolic blood pressure (SBP) <140 mm Hg from annual standardized assessments over time were compared with generalized estimating equations.
Across 4 years among 480 Look AHEAD and 1,129 ACCORD participants with baseline SBPs between 130 and 159 mm Hg, ILI (OR = 1.46; 95% CI = [1.18-1.81]) and frequent goal-based monitoring with pharmacotherapy (OR = 1.51; 95% CI = [1.16-1.97]) yielded higher rates of blood pressure control compared to education and support. The intensive behavioral-based intervention may have been more effective among individuals with body mass index >30 kg/m2, while frequent goal-based monitoring with medication management may be more effective among individuals with lower body mass index (interaction P = 0.047).
Among overweight and obese adults with type 2 diabetes, both ILI and frequent goal-based monitoring with pharmacological management can be successful strategies for blood pressure control.
clinicaltrials.gov identifiers NCT00017953 (Look AHEAD) and NCT00000620 (ACCORD).
Details
- Title: Subtitle
- Systolic Blood Pressure Control Among Individuals With Type 2 Diabetes: A Comparative Effectiveness Analysis of Three Interventions
- Creators
- Mark A Espeland - Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; mespelan@wakehealth.eduJeffery Probstfield - University of Washington, Seattle, Washington, USADonald Hire - Wake Forest School of Medicine, Winston-Salem, North Carolina, USAJ Bruce Redmon - University of Minnesota, Minneapolis, Minnesota, USAGregory W Evans - Wake Forest School of Medicine, Winston-Salem, North Carolina, USAMace Coday - The University of Tennessee Health Science Center, Memphis, Tennessee, USACora E Lewis - The University of Alabama at Birmingham, Birmingham, Alabama, USAKaren C Johnson - The University of Tennessee Health Science Center, Memphis, Tennessee, USASharon Wilmoth - Wake Forest School of Medicine, Winston-Salem, North Carolina, USAJudy Bahnson - Wake Forest School of Medicine, Winston-Salem, North Carolina, USAMichael F Dulin - Carolinas Medical Center, Charlotte, North Carolina, USAJennifer B Green - Duke University Medical Center, Durham, North Carolina, USAWilliam C Knowler - Diabetes Epidemiology and Clinical Research Section, NIDDK, Phoenix, Arizona, USAAbbas Kitabchi - The University of Tennessee Health Science Center, Memphis, Tennessee, USAAnne L Murillo - University of Washington, Seattle, Washington, USAKwame Osei - Internal Medicine, Ohio State University, Columbus, Ohio, USAShakaib U Rehman - Phoenix VA Health Care System, Phoenix, Arizona, USAWilliam C Cushman - Veterans Affairs Medical Center, Memphis, Memphis, Tennessee, USALook AHEAD Research GroupACCORD Study Group
- Contributors
- L Snetselaar (Contributor) - University of Iowa, Fraternal Order of Eagles Diabetes Research Center
- Resource Type
- Journal article
- Publication Details
- American journal of hypertension, Vol.28(8), pp.995-1009
- DOI
- 10.1093/ajh/hpu292
- PMID
- 25666468
- PMCID
- PMC4506323
- ISSN
- 0895-7061
- eISSN
- 1879-1905
- Grant note
- DK57135 / NIDDK NIH HHS P30 DK048520 / NIDDK NIH HHS DK57154 / NIDDK NIH HHS DK57151 / NIDDK NIH HHS U01 DK057149 / NIDDK NIH HHS P30 DK046204 / NIDDK NIH HHS U01 DK057131 / NIDDK NIH HHS U01 DK057078 / NIDDK NIH HHS P30 DK098722 / NIDDK NIH HHS DK 046204 / NIDDK NIH HHS Intramural NIH HHS P30 DK079626 / NIDDK NIH HHS M01 RR000056 / NCRR NIH HHS N01-HC-95181 / NHLBI NIH HHS M01RR00051 / NCRR NIH HHS DK57078 / NIDDK NIH HHS U01 DK056990 / NIDDK NIH HHS DK57182 / NIDDK NIH HHS DK57131 / NIDDK NIH HHS Y1-HC-9035 / NHLBI NIH HHS T32 AI007244 / NIAID NIH HHS DK57136 / NIDDK NIH HHS P30 DK026687 / NIDDK NIH HHS N01-HC-95182 / NHLBI NIH HHS UL1 TR001120 / NCATS NIH HHS U01 DK057178 / NIDDK NIH HHS DK57149 / NIDDK NIH HHS N01-HC-95178 / NHLBI NIH HHS UL1 TR000170 / NCATS NIH HHS M01 RR001346 / NCRR NIH HHS M01RR000056 / NCRR NIH HHS M01 RR002719 / NCRR NIH HHS P30 DK48520 / NIDDK NIH HHS N01-HC-95180 / NHLBI NIH HHS DK57002 / NIDDK NIH HHS DK57178 / NIDDK NIH HHS U01 DK057136 / NIDDK NIH HHS U01 DK057008 / NIDDK NIH HHS U01 DK057171 / NIDDK NIH HHS U01 DK056992 / NIDDK NIH HHS N01-HC-95183 / NHLBI NIH HHS Y1-HC-1010 / NHLBI NIH HHS UL1 RR024153 / NCRR NIH HHS DK57171 / NIDDK NIH HHS U01 DK057177 / NIDDK NIH HHS M01RR01066 / NCRR NIH HHS DK57219 / NIDDK NIH HHS U01 DK057182 / NIDDK NIH HHS N01-HC-95179 / NHLBI NIH HHS N01-HC-95184 / NHLBI NIH HHS M01RR01346 / NCRR NIH HHS UL1 RR 024153 / NCRR NIH HHS DK56992 / NIDDK NIH HHS M01 RR001066 / NCRR NIH HHS U01 DK057151 / NIDDK NIH HHS M01RR0021140 / NCRR NIH HHS DK57177 / NIDDK NIH HHS DK56990 / NIDDK NIH HHS M01 RR000051 / NCRR NIH HHS U01 DK057219 / NIDDK NIH HHS U01 DK057135 / NIDDK NIH HHS M01RR02719 / NCRR NIH HHS U01 DK057002 / NIDDK NIH HHS U01 DK057154 / NIDDK NIH HHS DK57008 / NIDDK NIH HHS UL1 TR001082 / NCATS NIH HHS
- Language
- English
- Date published
- 08/2015
- Academic Unit
- Epidemiology; Fraternal Order of Eagles Diabetes Research Center; Internal Medicine
- Record Identifier
- 9984215045702771
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