Effect of Intensive Versus Standard Blood Pressure Control on Depression and Health-Related Quality of Life in Type 2 Diabetes The ACCORD trial

• Authors: Patrick J. O'Connor, Health Partners Research Foundation; Kabayam Venkat Narayan, Emory University; KMV Narayan, Emory University; Roger Anderson, Pennsylvania State University; Patricia Feeney, Wake Forest University Health Sciences; Larry Fine, National Institutes of Health; Mohammed Ali, Emory University; Debra L. Simmons, University of Arkansas; Don G. Hire, Wake Forest University Health Sciences; JoAnn M. Sperl-Hillen, Health Partners Research Foundation; Lois Anne Katz, VA New York Harbor Healthcare System; Karen L. Margolis, Health Partners Research Foundation; Mark D. Sullivan, University of Washington
• Journal Title: Diabetes Care
• Volume: Volume 35, Number 7
• Publisher: American Diabetes Association | 2012-07-01, Pages 1479-1481
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.2337/dc11-1868
• Subjects: Health Sciences, Epidemiology; Health Sciences, Public Health
• Keywords: Science & Technology; Life Sciences & Biomedicine; Endocrinology & Metabolism; ENDOCRINOLOGY & METABOLISM; MELLITUS; HYPERTENSION

Abstract

OBJECTIVE - We tested the hypothesis that intensive (systolic blood pressure [SBP] < 120 mmHg) rather than standard (SBP 130-139 mmHg) blood pressure (BP) control improves health-related quality of life (HRQL) in those with type 2 diabetes. RESEARCH DESIGN AND METHODS - Subjects were 1,028 ACCORD (Action to Control Cardiovascular Risk in Diabetes) BP trial HRQL substudy participants who completed baseline and one or more 12-, 36-, or 48-month HRQL evaluations. Multivariable linear regression assessed impact of BP treatment assignment on change in HRQL. RESULTS - Over 4.0 years of follow-up, no significant differences occurred in five of six HRQL measures. Those assigned to intensive (vs. standard) BP control had statistically significant worsening of the Medical Outcomes Study 36-item short-form health survey (SF36) physical component scores (-0.8 vs. -0.2; P = 0.02), but magnitude of change was not clinically significant. Findings persisted across all prespecified subgroups. CONCLUSIONS - Intensive BP control in the ACCORD trial did not have a clinically significant impact, either positive or negative, on depression or patient-reported HRQL.