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Effects of intensive systolic BP treatment similar between prediabetes, normoglycemia

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August 10, 2017

Intensive and standard systolic blood pressure treatments were comparable among adults with prediabetes and normoglycemia, resulting in similar effects on cardiovascular outcomes and all-cause mortality, according to a study.

Adam P. Bress, PharmD, MS, assistant professor in the department of population health sciences, division of health system innovation and research at the University of Utah in Salt Lake City, and colleagues evaluated data from the Systolic Blood Pressure Intervention Trial (SPRINT) on 9,361 adults (mean age, 67.9 years; 35.5% women) randomly assigned to intensive (< 120 mm Hg) or standard (< 140 mm Hg) systolic BP treatment. Researchers sought to determine the effects of each treatment on a composite of myocardial infarction, acute coronary syndrome not resulting in MI, stroke, acute decompensated heart failure or death from CV causes. At baseline, 3,898 participants had prediabetes and 5,425 had normoglycemia, and median follow-up was 3.26 years.

At 1 year, mean systolic BP was 120.7 mm Hg for the intensive systolic BP treatment group and 136.2 mm Hg for the standard systolic BP treatment group in participants with prediabetes and 121.8 mm Hg for the intensive group and 136.2 mm Hg for the standard group in participants with normoglycemia.

The HRs for the composite outcome were 0.69 (95% CI, 0.53-0.89) for participants with prediabetes and 0.83 (95% CI, 0.66-1.03) for participants with normoglycemia, and the HRs for all-cause mortality were 0.77 (95% CI, 0.55-1.06) for participants with prediabetes and 0.71 (95% CI, 0.54-0.94) for participants with normoglycemia.

Similar effects were found for both treatments for prespecified renal outcomes and serious adverse events in participants with prediabetes or normoglycemia.

“Among U.S. adults at high CVD risk but without clinical diabetes, the beneficial effects of intensive [systolic] BP treatment to < 120 mm Hg compared with standard [systolic] BP treatment < 140 mm Hg on the reduction of CVD events and all-cause mortality were similar among those with prediabetes and fasting normoglycemia,” the researchers wrote. – by Amber Cox

Disclosures: Bress reports having an institutional grant from Novartis not related to this project. Please see the study for all other authors’ relevant financial disclosures.