Key result
In 2,847 nondiabetic patients receiving intensive blood pressure treatment, thiazide use was associated with a significantly decreased risk of cardiovascular events over 3.3 years.
Why the study?
It remained unknown whether specific medications can further improve cardiovascular outcomes in patients receiving intensive BP treatment.
Does thiazide use reduce cardiovascular events in nondiabetic high-risk patients receiving intensive blood pressure treatment?
Cohort (n=2,847)
Does thiazide use reduce cardiovascular events in nondiabetic high-risk patients receiving intensive blood pressure treatment?
In nondiabetic high-risk patients receiving intensive blood pressure lowering, thiazide use is associated with a decreased risk of cardiovascular events, particularly heart failure, and all-cause mortality.
May support thiazide preference during intensive BP control; hypothesis-generating and requires randomized confirmation.
The SPRINT (Systolic Blood Pressure Intervention Trial) study reported that intensive blood pressure (BP) treatment with a systolic BP target of <120 mm Hg decreased the risks of cardiovascular events. However, it remains unknown whether specific medications can further improve cardiovascular outcome in patients receiving intensive BP treatment. This study examined whether thiazide use improves cardiovascular outcome in patients receiving intensive BP treatment. We used data of nondiabetic patients receiving intensive BP treatment in the SPRINT study. The primary outcome was a composite end point of myocardial infarction, acute coronary syndrome, stroke, heart failure, or cardiovascular death. We analyzed hazard ratios for outcomes with 95% CIs in patients taking thiazides compared with those not taking thiazides using Cox proportional hazard models. This study included 2847 patients and the mean follow-up period was 3.3 years. The risk of primary outcome events was significantly lower in patients taking thiazides than in those not taking thiazides in both entire and propensity score-matched cohorts. Particularly, heart failure risk was significantly lower in those taking thiazides. These associations were also observed in various subgroups. In addition, thiazide use was associated with decreased risk of all-cause mortality. Hypokalemia occurred more frequently in patients taking thiazides than in those not taking thiazides. Thiazide use decreased risk of cardiovascular events, particularly heart failure, in nondiabetic high-risk patients receiving intensive BP treatment.
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Tsujimoto et al. (2020) conducted a cohort in Nondiabetic patients receiving intensive blood pressure treatment (n=2,847). Thiazide use vs. No thiazide use was evaluated on Composite of myocardial infarction, acute coronary syndrome, stroke, heart failure, or cardiovascular death. In 2,847 nondiabetic patients receiving intensive blood pressure treatment, thiazide use was associated with a significantly decreased risk of cardiovascular events over 3.3 years.
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