Effects of Intensive Blood Pressure Control in Patients with Evident Cardiovascular Disease: An Investigation Using the SPRINT Study Data

Author(s): Charalambos Vlachopoulos*, Dimitrios Terentes-Printzios, Konstantinos Aznaouridis, Nikolaos Ioakeimidis, Panagiotis Xaplanteris, Georgios Lazaros, Dimitrios Tousoulis.

Journal Name: Current Vascular Pharmacology

Volume 17 , Issue 3 , 2019

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Graphical Abstract:


Background: Recent data advocate adoption of a more intensive treatment strategy for management of blood pressure (BP).

Objective: We investigated whether the overall effects of the Systolic Blood Pressure Intervention Trial (SPRINT) are applicable to cardiovascular disease (CVD) patients.

Methods: In a post hoc analysis we analyzed data from SPRINT that randomly assigned 9361 individuals to a systolic BP (SBP) target of <120 mmHg (intensive treatment) or <140 mmHg (standard treatment). 1562 patients had clinically evident CVD (age=70.3±9.3 years, 24% females) at study entry and were followed for 3.1 years. Further, we assessed the effect of low (<150 mmHg) baseline SBP on outcome.

Results: In CVD patients, there was no benefit from the intensive treatment regarding all endpoints, except for a marginally significant benefit on all-cause mortality (hazard ratio [HR]: 0.67; 95% confidence interval [CI], 0.45 to 1.00; p=0.0509). Further, while there was no increase in serious adverse events (SAE) in the intensive group, there was increased risk for study-related SAE, acute renal failure and electrolyte abnormalities. In patients with low baseline SBP there was a beneficial effect on allcause mortality (HR: 0.56; 95% CI: 0.33 to 0.96; p=0.033), but with greater stroke incidence (HR: 2.94; 95% CI: 1.04 to 8.29; p=0.042).

Conclusion: We confirm the beneficial effect of the intensive strategy in SPRINT study on all-cause mortality and the harmful effect on specific adverse outcomes in patients with CVD. However, in patients with low baseline SBP stroke may increase.

Keywords: Hypertension, blood pressure, intensive, cardiovascular disease, stroke, acute renal failure.

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Article Details

Year: 2019
Page: [298 - 306]
Pages: 9
DOI: 10.2174/1570161116666180305160116
Price: $58

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