Intensive BP lowering offers similar benefits in prediabetes vs standard treatment

  • Diabetes Care

  • from Sarfaroj Khan
  • Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • The beneficial effects of intensive Systolic BP (SBP) treatment (

Why this matters

  • Given the inconsistent results of the overall Systolic Blood Pressure Intervention Trial (SPRINT) trial, the analysis of the effect of intensive BP treatment in high-risk patients with prediabetes vs normoglycemia is important.

Study design

  • 9361 SPRINT participants were categorized as prediabetic (baseline fasting serum glucose ≥ 100 mg/dL, n=3898) and normoglycemic (fasting serum glucose
  • Primary outcome was a composite of myocardial infarction, acute coronary syndrome.
  • Funding: SPRINT is funded by the National institutes of health.

Key results

  • Among those with prediabetes and normoglycemia, the HR for the primary outcome was 0.69 and 0.83, respectively (P for interaction .30) (median follow-up 3.26 y).
  • The HR with intensive SBP treatment for all-cause mortality was:

         — 0.77 (95% CI, 0.55-1.06) for prediabetes

         — 0.71 (95% CI 0.54, 0.94) for normoglycemia

  • For prediabetes and normoglycemia, the effects of intensive vs standard SBP treatment on prespecified renal outcomes and serious adverse events were similar (all interaction P>.05).

Limitations

  • Lack of data on HbA1c.