{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T02:58:13Z","timestamp":1791428293253,"version":"4.3.3"},"reference-count":21,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Nephrol"],"published-print":{"date-parts":[[2016]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Background:&lt;\/i&gt;&lt;\/b&gt; Persons with chronic kidney disease (CKD) represent a population prone to cardiovascular disease (CVD) but vulnerable to adverse medication effects. We assessed the impact of intensive antihypertensive therapy on the cerebrovascular and other CVD outcomes in high-risk patients with type 2 diabetes and baseline CKD. &lt;b&gt;&lt;i&gt;Methods:&lt;\/i&gt;&lt;\/b&gt; Using current guideline criteria, 1,726 (36.9%) of 4,678 participants in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) blood pressure (BP) arm had mild to moderate CKD (CKD1-3B) at baseline. Participants of this study were randomized to intensive (systolic &lt;120 mm Hg) or standard (systolic &lt;140 mm Hg) BP goals. Fatal and non-fatal stroke were pre-specified secondary outcomes of the ACCORD study. &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; Total cerebrovascular events were significantly higher in participants with baseline CKD (0.66%\/year) compared with participants free of CKD (0.28%\/year). A significantly higher rate of events was observed in CKD participants. Intensive antihypertensive therapy in participants without CKD at baseline resulted in a 55% significant reduction of any stroke (hazard ratio 0.447; 95% CI 0.227-0.880) and a 50% reduction of non-fatal stroke (hazard ratio 0.498; 95% CI 0.250-0.993). In participants with CKD at baseline, the occurrence of any stroke was reduced by 38% (hazard ratio 0.623; 95% CI 0.361-1.074) and non-fatal stroke by 36% (hazard ratio 0.642; 95% CI 0.361-1.142). Test for interaction was NS between the 2 groups. Changes in other CVD outcomes did not reach statistical significance. &lt;b&gt;&lt;i&gt;Conclusions:&lt;\/i&gt;&lt;\/b&gt; These findings suggest that intensive antihypertensive therapy offers significant cerebrovascular protection in diabetic participants without CKD at baseline, but significant benefit to patients with CKD cannot be excluded.<\/jats:p>","DOI":"10.1159\/000446122","type":"journal-article","created":{"date-parts":[[2016,4,28]],"date-time":"2016-04-28T21:25:06Z","timestamp":1461878706000},"page":"271-280","source":"Crossref","is-referenced-by-count":46,"title":["Cardiovascular Outcomes in Action to Control Cardiovascular Risk in Diabetes: Impact of Blood Pressure Level and Presence of Kidney Disease"],"prefix":"10.1159","volume":"43","author":[{"given":"Vasilios","family":"Papademetriou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misbah","family":"Zaheer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Doumas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Lovato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William B.","family":"Applegate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costas","family":"Tsioufis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Mottle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zubin","family":"Punthakee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Cushman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"ACCORD Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2016,4,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-139-2-200307150-00013"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60572-8"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2010.522"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2004.03.003"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1511939"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1001286"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0802743"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1001282"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.17.2038"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041031"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60674-5"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2008.12.036"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61303-8"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1991.03460240051027"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)04311-6"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7258.412"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)05381-6"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.18574"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199403313301301"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0910975"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2014.296"}],"container-title":["American Journal of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/446122","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/446122","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T18:04:46Z","timestamp":1745431486000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000446122"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016]]},"references-count":21,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2016,6,6]]}},"URL":"https:\/\/doi.org\/10.1159\/000446122","archive":["Portico"],"relation":{},"ISSN":["0250-8095","1421-9670"],"issn-type":[{"value":"0250-8095","type":"print"},{"value":"1421-9670","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016]]}}}