Key result
Intensive BP control lowers HF risk consistently regardless of kidney function or albuminuria.
Why the study?
It was unclear whether an intensive blood pressure control strategy reduces the risk of heart failure events consistently across the spectrum of kidney function and albuminuria.
Does intensive blood pressure control reduce the risk of heart failure events consistently across the spectrum of kidney function and albuminuria?
RCT
Does intensive blood pressure control reduce the risk of heart failure events consistently across the spectrum of kidney function and albuminuria?
Intensive blood pressure control reduces heart failure risk consistently across varying levels of kidney function and albuminuria.
Supports intensive BP control to reduce HF risk across kidney function levels; confirms consistent benefit irrespective of eGFR or albuminuria.
AIMS: To determine whether a strategy of intensive blood pressure control reduces the risk of heart failure (HF) events consistently across the spectrum of kidney function and albuminuria. METHODS AND RESULTS: and UACR >300 mg/g. A similar gradient was observed for HF events alone. Both eGFR and UACR were independently, non-linearly associated with HF hospitalization and HF hospitalization or cardiovascular death (test for overall trend, P < 0.001). While the effects of intensive blood pressure control on HF event risk appeared to attenuate at lower eGFR and higher UACR, there was no significant interaction between eGFR or UACR and blood pressure control strategy (continuous and categorical interaction P > 0.05). CONCLUSION: In SPRINT, eGFR and albuminuria were strong and additive determinants in forecasting HF risk. The effect of intensive blood pressure control in decreasing HF risk did not significantly vary across the spectrum of kidney function or albuminuria. Multidisciplinary pathways, incorporating blood pressure control, are needed for at-risk patients with chronic kidney disease to attenuate HF risk. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT01206062.
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Vaduganathan et al. (2020) conducted an RCT in Heart failure risk across the spectrum of kidney function and albuminuria. Intensive blood pressure control vs. Standard blood pressure control was evaluated on Heart failure hospitalization and heart failure hospitalization or cardiovascular death (p=>0.05). The effect of intensive blood pressure control in decreasing heart failure risk did not significantly vary across the spectrum of kidney function or albuminuria (interaction P > 0.05).
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