Intensive blood sugar and BP control lowers cardiac autonomic neuropathy risk in diabetes

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-01-09T10:56:18+05:30 | Updated On 9 Jan 2021 1:56 PM IST

USA: Treatment with tighter blood sugar and blood pressure targets decreases risk of cardiovascular autonomic neuropathy (CAN) in type 2 diabetes (T2D) patients at high risk for cardiovascular events, finds a recent study in the journal Diabetes Care. The results were obtained from posthoc analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study.

The effective preventive interventions for CAN remain unclear. Yaling Tang, Joslin Diabetes Center and Harvard Medical School, Boston, Massachusetts, and colleagues therefore, examined the effect of intensively treating traditional risk factors for CAN, including dyslipidemia, hypertension, and hyperglycemia in patients with type 2 diabetes and high cardiovascular risk participating in the ACCORD trial.

CAN was defined as heart rate variability indices below the fifth percentile of the normal distribution. 71% (n = 7,275) of 10,251 ACCORD participants underwent a CAN evaluation at study entry and at least once after randomization. Using generalized linear mixed models, the effects of intensive interventions on CAN were analyzed among these subjects.

Key findings of the study include:

As compared with standard intervention, intensive glucose treatment reduced CAN risk by 16% (odds ratio [OR] 0.84)—an effect driven by individuals without cardiovascular disease (CVD) at baseline (OR 0.73) rather than those with CVD (OR 1.10).
Intensive blood pressure (BP) intervention decreased CAN risk by 25% (OR 0.75), especially in patients ≥65 years old (OR 0.66).
Fenofibrate did not have a significant effect on CAN (OR 0.91).

"These data confirm a beneficial effect of intensive glycemic therapy and demonstrate, for the first time, a similar benefit of intensive BP control on CAN in T2D. A negative CVD history identifies T2D patients who especially benefit from intensive glycemic control for CAN prevention," wrote the authors.

"Intensive Risk Factor Management and Cardiovascular Autonomic Neuropathy in Type 2 Diabetes: The ACCORD Trial," is published in the journal Diabetes Care.

DOI: https://care.diabetesjournals.org/content/early/2020/11/02/dc20-1842

Diabetes CareACCORD TrialCardiac Autonomic Neuropathyblood sugartype 2 diabetesblood pressure

Source : Diabetes Care

Medha Baranwal

MSc. Biotechnology

Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751