How to Handle the Creatinine “Bump”—Analysis of ACCORD-BP Data

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For patients with type 2 diabetes, increases in serum creatinine after starting blood pressure–lowering treatment—even greater than 30%—do not necessarily mean that antihypertensive therapy should be decreased, reports a study in Hypertension.

The researchers performed a post hoc analysis of data from the ACCORD-BP (Action to Control Cardiovascular Risk in Diabetes Blood Pressure) trial, which compared intensive versus standard BP-lowering therapy (systolic BP cutoffs of 120 and 140 mm Hg, respectively). The analysis included 4733 patients with type 2 diabetes. Mean age was 62.2 years, with a mean estimated glomerular filtration rate of 81.5 mL/min/1.73 m2.