- For resistant hypertension, intensive BP treatment reduces risk for major adverse cardiovascular events (MACE), with tradeoff of more syncope, hyponatremia.
- Patient population from SPRINT study.
Why this matters
- Evidence supporting aggressive BP targeting in resistant hypertension is limited, say the authors.
- This study looked at targeting
- Vs standard target, MACE risk was reduced with intensive targeting in resistant hypertension group:
- HR, 0.62 (95% CI, 0.40-0.96; P=.03).
- Vs standard target, death risk was also reduced with intensive targeting:
- All-cause death: HR, 0.60 (95% CI, 0.38-0.97; P=.03);
- Cardiovascular death: HR, 0.34 (95% CI, 0.15-0.81; P=.01).
- These risk reductions were steeper than for those without resistant hypertension.
- Using 2008 vs 2018 American Heart Association resistant hypertension definitions yielded similar outcomes.
- Patients with resistant hypertension ≥140/90 mmHg and taking 3+ antihypertensives also had similar risk reductions with intensive targeting.
- Syncope, hyponatremia risks elevated with intensive targeting.
- Secondary analysis of SPRINT (Systolic Blood Pressure Intervention Trial), including 1397 with resistant hypertension (n=705, standard target; n=692, intensive target), 7698 without.
- Funding: Japan Society for the Promotion of Science.
- Low statistical power.