Key result
Intensive blood pressure control resulted in a statistically but not clinically significant worsening of SF36 physical component scores vs standard control (-0.8 vs -0.2; P=0.02) in type 2 diabetes.
Why the study?
Does intensive blood pressure control improve health-related quality of life and depression in patients with type 2 diabetes?
RCT (n=1,028)
Does intensive blood pressure control improve health-related quality of life and depression in patients with type 2 diabetes?
Intensive blood pressure targeting (SBP <120 mmHg) in type 2 diabetes does not meaningfully alter patient-reported quality of life or depression compared to standard targeting.
Answers are grounded in this paper and cite their sources.
No clinically meaningful HRQoL impact with intensive BP control in T2D; confirms neutral effects on patient-reported outcomes.
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.
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O’Connor et al. (2012) conducted an RCT in Type 2 diabetes (n=1,028). Intensive blood pressure control vs. Standard blood pressure control (SBP 130-139 mmHg) was evaluated on Change in health-related quality of life (SF36 physical component score) (p=0.02). Intensive blood pressure control resulted in a statistically but not clinically significant worsening of SF36 physical component scores vs standard control (-0.8 vs -0.2; P=0.02) in type 2 diabetes.
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