title: Effect of intensive versus standard blood pressure control on depression and health-related quality of life in type 2 diabetes: the ACCORD trial.
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.
  
  
  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.
authors.affiliation: HealthPartners Research Foundation, Minneapolis, MN, USA. patrick.j.oconnor@healthpartners.com
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: O'Connor
authors.forename: K M Venkat
authors.initials: KM
authors.lastname: Narayan
authors.forename: Roger
authors.initials: R
authors.lastname: Anderson
authors.forename: Patricia
authors.initials: P
authors.lastname: Feeney
authors.forename: Larry
authors.initials: L
authors.lastname: Fine
authors.forename: Mohammed K
authors.initials: MK
authors.lastname: Ali
authors.forename: Debra L
authors.initials: DL
authors.lastname: Simmons
authors.forename: Don G
authors.initials: DG
authors.lastname: Hire
authors.forename: JoAnn M
authors.initials: JM
authors.lastname: Sperl-Hillen
authors.forename: Lois Anne
authors.initials: LA
authors.lastname: Katz
authors.forename: Karen L
authors.initials: KL
authors.lastname: Margolis
authors.forename: Mark D
authors.initials: MD
authors.lastname: Sullivan
mesh_terms: D001794:Blood Pressure / Q000187:drug effects*; D003863:Depression; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D011788:Quality of Life