{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:42:22Z","timestamp":1772160142570,"version":"3.50.1"},"reference-count":46,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T00:00:00Z","timestamp":1706659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100017618","name":"Division of Diabetes, Endocrinology, and Metabolic Diseases","doi-asserted-by":"publisher","award":["1R01DK133465"],"award-info":[{"award-number":["1R01DK133465"]}],"id":[{"id":"10.13039\/100017618","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K08CA248972"],"award-info":[{"award-number":["K08CA248972"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The action to control cardiovascular risk in diabetes (ACCORD) trial showed a neutral average treatment effect of intensive blood glucose and blood pressure (BP) controls in preventing major adverse cardiovascular events (MACE) in individuals with type 2 diabetes. Yet, treatment effects across patient subgroups have not been well understood. We aimed to identify patient subgroups that might benefit from intensive glucose or BP controls for preventing MACE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>As a post\u2010hoc analysis of the ACCORD trial, we included 10\u2009251 individuals with type 2 diabetes. We applied causal forest and causal tree models to identify participant characteristics that modify the efficacy of intensive glucose or BP controls from 68 candidate variables (demographics, comorbidities, medications and biomarkers) at the baseline. The exposure was (a) intensive versus standard glucose control [glycated haemoglobin (HbA1c) &lt;6.0% vs. 7.0%\u20107.9%], and (b) intensive versus standard BP control (systolic BP &lt;120 vs. &lt;140\u2009mmHg). The primary outcome was MACE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with standard glucose control, intensive one reduced MACE in those with baseline HbA1c &lt;8.5% [relative risk (RR): 0.79, 95% confidence interval (CI): 0.67\u20100.93] and those with estimated glomerular filtration rate \u2265106\u2009ml\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      (RR: 0.74, 95% CI: 0.55\u20100.99). Intensive BP control reduced MACE in those with normal high\u2010density lipoprotein levels (women &gt;55\u2009mg\/dl, men &gt;45\u2009mg\/dl; RR: 0.51, 95% CI: 0.34\u20100.74). Risk reductions were not significant in other patient subgroups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest heterogeneous treatment effects of intensive glucose and BP control and could provide biomarkers for future clinical trials to identify more precise HbA1c and BP treatment goals for individualized medicine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.15453","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T02:00:09Z","timestamp":1706752809000},"page":"1502-1509","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Some patients with type 2 diabetes may benefit from intensive glycaemic and blood pressure control: A post\u2010hoc machine learning analysis of\n                    <scp>ACCORD<\/scp>\n                    trial data"],"prefix":"10.1111","volume":"26","author":[{"given":"Tianze","family":"Jiao","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Outcomes and Policy, College of Pharmacy University of Florida  Gainesville Florida USA"},{"name":"Center for Drug Evaluation and Safety (CoDES) University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamed","family":"Kianmehr","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Outcomes and Policy, College of Pharmacy University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7040-4287","authenticated-orcid":false,"given":"Yilu","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, School of Public Health and Tropical Medicine Tulane University  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0941-5563","authenticated-orcid":false,"given":"Piaopiao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Outcomes and Policy, College of Pharmacy University of Florida  Gainesville Florida USA"},{"name":"Hubert Department of Global Health, Rollin School of Public Health Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naykky","family":"Singh Ospina","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Metabolism University of Florida College of Medicine  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans K.","family":"Ghayee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism University of Florida College of Medicine, Malcom Randall VA Medical Center  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Ruzieh","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiovascular Medicine University of Florida College of Medicine  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3381-7151","authenticated-orcid":false,"given":"Vivian","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Department of Medicine and Pharmacology, School of Medicine Tulane University  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7827-6766","authenticated-orcid":false,"given":"Lizheng","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, School of Public Health and Tropical Medicine Tulane University  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Diabetes Translation Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4088-546X","authenticated-orcid":false,"given":"Hui","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Outcomes and Policy, College of Pharmacy University of Florida  Gainesville Florida USA"},{"name":"Center for Drug Evaluation and Safety (CoDES) University of Florida  Gainesville Florida USA"},{"name":"Hubert Department of Global Health, Rollin School of Public Health Emory University  Atlanta Georgia USA"},{"name":"Department of Family and Preventive Medicine, School of Medicine Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,31]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.1997.tb00006.x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003882"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18\u20102047"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v7.i17.354"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.2007.S33"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(10)60576\u20104"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0802987"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0808431"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc21\u2010Sppc"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/M17\u20100939"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1006524"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2017020148"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0802743"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.2337\/db09\u20100618"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102021\u2010050335"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1510489113"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1214\/18\u2010AOS1709"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.2017.1319839"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1001282"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2007.03.003"},{"key":"e_1_2_11_22_1","volume-title":"Relative Risk, Relative and Absolute Risk Reduction, Number Needed to Treat and Confidence Intervals","author":"Irwig L","year":"2008"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1353\/obs.2019.0001"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17\u20102252"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933\u2010022\u201001496\u20107"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19\u20101817"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.632704"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc22\u20102521"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325\u2010018\u20100824\u20108"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.obpill.2022.100045"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.405"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41440\u2010023\u201001185\u20102"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18\u20101144"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b4909"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc15\u20102322"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2016060666"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.2337\/dbi16\u20100056"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12\u20101408"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm4050948"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1517\/17425255.2013.777428"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI109144"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc22\u2010S006"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(15)00805\u20103"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i717"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.778756"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYP.0000000000000065"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14888"}],"container-title":["Diabetes, Obesity and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/pdf\/10.1111\/dom.15453","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:33:35Z","timestamp":1761870815000},"score":1,"resource":{"primary":{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/10.1111\/dom.15453"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,31]]},"references-count":46,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/dom.15453"],"URL":"https:\/\/doi.org\/10.1111\/dom.15453","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/DOM.15453\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15453\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15453\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15453\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15453\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15453\/v2\/decision1","asserted-by":"object"}]},"ISSN":["1462-8902","1463-1326"],"issn-type":[{"value":"1462-8902","type":"print"},{"value":"1463-1326","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,31]]},"assertion":[{"value":"2023-08-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}