March 16, 2010 -- Research led by Dr. William C. Cushman of the VA Medical Center in Memphis is the focus of an article published Sunday in The New England Journal of Medicine.

Cushman, the hospitals chief of preventive medicine, is the lead author of the article about a nationwide, eight-year study to determine whether more intensive drug therapies are needed for diabetics at risk for heart disease.

The landmark study is one of the largest ever conducted in adults with Type 2 diabetes at risk for heart disease and strokes, according to the National Institutes of Health. The study found that taking more medications did not lead to better health outcomes.

The acronym for the study is ACCORD, which stands for Action to Control Cardiovascular Risk in Diabetes.

The study was primarily funded by the National Heart, Lung and Blood Institute.

The research actually involved three trials using drugs that are already on the market.

It weighed the benefits of using medications to reach set goals for blood pressure. It monitored the effect of achieving lower levels of blood sugar and tracked results with lipid therapy to control triglycerides and cholesterol.

Cushman presented the results of the blood pressure trial Sunday in Atlanta at the annual scientific sessions of the American College of Cardiology.

The New England Journal of Medicine released the article simultaneously with Cushmans presentation.

He served as national chairman of the blood pressure study, but took part in all three portions if the trial.

The blood pressure trial involved 4,733 participants, including almost 200 from the VA Medical Center in Memphis.

It tested whether treating systolic blood pressure, which is the top of the two numbers, down to a level in the normal range of less than 120 will reduce cardiovascular events compared to the usual goal of less than 140, Cushman said.

The doctors were able to achieve the desired lower blood pressure in patients.

Despite that, there was not a statistically significant benefit for those that were in the intensive group, Cushman said. They did have 12 percent fewer events, but that was not significant. We designed the study to see whether a 20 percent benefit would have been seen. It was not.

The bottom line for diabetics with high blood pressure is they can take less medication.

Probably about 18 million Americans have diabetes and hypertension together, he said. Instead of their needing three or four drugs just to lower their blood pressure down to this 120 range, most people with diabetes would need a lot fewer drugs  maybe two or even less to control their blood pressure below the standard range of 140.

The portion of the nationwide study to assess the benefits of achieving lower blood sugar levels involved more participants.

We started the trial in 2001 and we recruited 10,251 adults with Type 2 diabetes mellitus (adult onset diabetes) who were at risk for having cardiovascular events, Cushman said.

Half of patients had lower blood sugar.