Collard D, et al. - In the Action to Control Cardiovascular Risk in Diabetes Blood Pressure trial enrolling patients with type 2 diabetes mellitus, researchers assessed the link between increased serum creatinine and adverse clinical outcomes among patients with diabetes randomized to intensive (target systolic blood pressure level of <120 mm Hg) and standard antihypertensive (< 140 mm Hg) treatment. Patients were stratified into three groups according to serum creatinine increase between baseline and 4 months (< 10%, 10% to 30%, > 30%). A combined endpoint consisting of all-cause mortality, major cardiovascular events, and renal failure was assessed as the primary outcome. Findings revealed a higher risk of clinical adverse outcomes in relation to a > 30% serum creatinine increase in both treatment groups, but to a similar extent, after adjusting for possible confounders. The authors recommended a reduction in antihypertensive medication in patients with type 2 diabetes mellitus should not be made in correlation with a > 30% serum creatinine increase that coincides with lower BP values.