April 1, 2017Open Access
View Full PaperEffect of Intensive Blood Pressure Treatment on Heart Failure Events in the Systolic Blood Pressure Reduction Intervention Trial
Structured PICO
Does intensive blood pressure treatment targeting systolic BP <120 mm Hg reduce acute decompensated heart failure events compared to targeting <140 mm Hg in SPRINT participants?
P
Population
Participants in the Systolic Blood Pressure Intervention Trial (SPRINT), including subgroups of age ≥75 years, prior cardiovascular disease, chronic kidney disease, women, black race, and 3 levels of baseline systolic BP (≤132 versus >132 to <145 versus ≥145 mm Hg)
I
Intervention
Intensive blood pressure treatment targeting a systolic BP <120 mm Hg
C
Comparator
Blood pressure treatment targeting a systolic BP <140 mm Hg
O
Outcome
Acute decompensated heart failure (ADHF) eventshard clinical
Intensive blood pressure reduction to <120 mm Hg significantly prevents acute decompensated heart failure events across diverse patient subgroups.
Abstract
BACKGROUND: Acute decompensated heart failure (ADHF) was a frequent common outcome in SPRINT (Systolic Blood Pressure Intervention Trial). We examined whether there was differential reduction in ADHF events from intensive blood pressure BP treatment among the 6 key, prespecified subgroups in SPRINT: age ≥75 years, prior cardiovascular disease, chronic kidney disease, women, black race, and 3 levels of baseline systolic BP (≤132 versus >132 to <145 versus ≥145 mm Hg). METHODS AND RESULTS: <0.001) in cardiovascular death. CONCLUSIONS: Targeting a systolic BP<120 mm Hg, compared with <140 mm Hg, significantly reduced ADHF events, and the benefit was similar across all key, prespecified subgroups. Participants who developed ADHF had markedly increased risk for subsequent cardiovascular events and death, highlighting the importance of strategies aimed at prevention of ADHF, especially intensive BP reduction. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01206062.