Effect of Intensive Versus Standard Blood Pressure Treatment According to Baseline Prediabetes Status: A Post Hoc Analysis of a Randomized Trial.
Title | Effect of Intensive Versus Standard Blood Pressure Treatment According to Baseline Prediabetes Status: A Post Hoc Analysis of a Randomized Trial. |
Publication Type | Journal Article |
Year of Publication | 2017 |
Authors | Bress, A. P., King J. B., Kreider K. E., Beddhu S., Simmons D. L., Cheung A. K., Zhang Y., Doumas M., Nord J., Sweeney M. Ellen, Taylor A. A., Herring C., Kostis W. J., Powell J., Rastogi A., Roumie C. L., Wiggers A., Williams J. S., Yunis R., Zias A., Evans G. W., Greene T., Rocco M. V., Cushman W. C., Reboussin D. M., Feinglos M. N., & Papademetriou V. |
Corporate Authors | SPRINT Research Group |
Journal | Diabetes Care |
Date Published | 2017 Aug 09 |
ISSN | 1935-5548 |
Abstract | OBJECTIVE: To determine whether the effects of intensive (<120 mmHg) compared with standard (<140 mmHg) systolic blood pressure (SBP) treatment are different among those with prediabetes versus those with fasting normoglycemia at baseline in the Systolic Blood Pressure Intervention Trial (SPRINT).RESEARCH DESIGN AND METHODS: This was a post hoc analysis of SPRINT. SPRINT participants were categorized by prediabetes status, defined as baseline fasting serum glucose ≥100 mg/dL versus those with normoglycemia (fasting serum glucose <100 mg/dL). The primary outcome was a composite of myocardial infarction, acute coronary syndrome not resulting in myocardial infarction, stroke, acute decompensated heart failure, or death from cardiovascular causes. Cox regression was used to calculate hazard ratios for study outcomes with intensive compared with standard SBP treatment among those with prediabetes and normoglycemia.RESULTS: Among 9,361 participants randomized (age 67.9 ± 9.4 years; 35.5% female), 3,898 and 5,425 had baseline prediabetes and normoglycemia, respectively. After a median follow-up of 3.26 years, the hazard ratio for the primary outcome was 0.69 (95% CI 0.53, 0.89) and 0.83 (95% CI 0.66, 1.03) among those with prediabetes and normoglycemia, respectively ( value for interaction 0.30). For all-cause mortality, the hazard ratio with intensive SBP treatment was 0.77 (95% CI 0.55, 1.06) for prediabetes and 0.71 (95% CI 0.54, 0.94) for normoglycemia ( value for interaction 0.74). Effects of intensive versus standard SBP treatment on prespecified renal outcomes and serious adverse events were similar for prediabetes and normoglycemia (all interaction > 0.05).CONCLUSIONS: In SPRINT, the beneficial effects of intensive SBP treatment were similar among those with prediabetes and fasting normoglycemia. |
DOI | 10.2337/dc17-0885 |
Alternate Journal | Diabetes Care |
PubMed ID | 28793997 |
PubMed Central ID | PMC5606306 |
Grant List | UL1 TR000433 / TR / NCATS NIH HHS / United States K01 HL133468 / HL / NHLBI NIH HHS / United States UL1 TR000445 / TR / NCATS NIH HHS / United States HHSN268200900048C / HL / NHLBI NIH HHS / United States UL1 TR000005 / TR / NCATS NIH HHS / United States HHSN268200900040C / HL / NHLBI NIH HHS / United States HHSN268200900046C / HL / NHLBI NIH HHS / United States UL1 TR000064 / TR / NCATS NIH HHS / United States UL1 TR000075 / TR / NCATS NIH HHS / United States P30 GM103337 / GM / NIGMS NIH HHS / United States UL1 TR001064 / TR / NCATS NIH HHS / United States UL1 RR025752 / RR / NCRR NIH HHS / United States UL1 RR025771 / RR / NCRR NIH HHS / United States UL1 TR000093 / TR / NCATS NIH HHS / United States HHSN268200900049C / HL / NHLBI NIH HHS / United States HHSN268200900047C / HL / NHLBI NIH HHS / United States UL1 TR000003 / TR / NCATS NIH HHS / United States UL1 TR000050 / TR / NCATS NIH HHS / United States UL1 TR000439 / TR / NCATS NIH HHS / United States UL1 TR000073 / TR / NCATS NIH HHS / United States UL1 RR025755 / RR / NCRR NIH HHS / United States UL1 TR000002 / TR / NCATS NIH HHS / United States UL1 TR000105 / TR / NCATS NIH HHS / United States UL1 RR024134 / RR / NCRR NIH HHS / United States |