ACCORD stands for Action to Control Cardiovascular Risk in Diabetes. In people with diabetes good control of blood sugars, blood pressure and blood fats (cholesterol) has been shown to reduce the risk of heart attacks and strokes as well as the long-term complications of kidney and eye damage. With that in mind the question has been posed how good should control be in terms of maximizing benefits. How low do we need to go to maximize the benefits without compromising safety? What if we normalized these risk factors? What if we took a group of people with diabetes and tried to help them manage their blood sugars, blood pressure and blood cholesterol so that they were in the normal range for these factors? Would we see any differences as opposed to standard care/management? That is the question that the research study ACCORD is investigating.
ACCORD is a large multicentre clinical trial being funded by the National Heart Lung Blood Institute in the United States. There are approximately 70 centres though out North America and 12 centres in Canada including one in Vancouver. They will be recruiting a total of 10,000 volunteers to take part in this 7 year study of diabetes care including 132 volunteers at the Vancouver site.
The key comparisons in the study are:
- Standard blood sugar management (HbA1c 7.0-7.9%) vs intensive blood sugar management (HbA1c less than 6.0/)
- Standard blood pressure control (135-139 mmHg systolic BP) vs intensive management (systolic BP less than 120)
- Cholesterol: Standard therapy of 20 mg simvistatin vs intensive therapy of 20 mg simvistatin and 200 mg fenofibrate.