Intensive blood pressure lowering reduces adverse cardiovascular outcomes among patients with high-normal glucose: An analysis from the Systolic Blood Pressure Intervention Trial database

J Clin Hypertens (Greenwich). 2018 Apr;20(4):620-624. doi: 10.1111/jch.13247. Epub 2018 Mar 13.

Abstract

The objective of this analysis is to determine the effect of intensive (<120 mm Hg) versus standard (<140 mm Hg) systolic blood pressure (SBP) targets on cardiovascular (CV) outcomes among SPRINT participants with low-normal or high-normal fasting glucose (FG). We categorized the 5425 SPRINT participants with FG <100 mg/dL into 2 groups: <85 mg/dL (low-normal) and 85 to <100 mg/dL (high-normal). Among participants with low-normal glucose, there was no significant difference in the primary outcome (PO) between the 2 treatment arms (adjusted hazard ratio, HR: 1.27 (95% confidence interval [CI] 0.68-2.37, P = .46). However, the intensive SBP target was associated with 27% lower risk for the PO compared with the standard SBP target in those with high-normal glucose (HR 0.73, 0.57-0.93, P = .01). Our results indicate that hypertensive patients with high-normal FG may benefit from intensive SBP lowering, whereas benefits were inconclusive among those with low-normal FG.

Keywords: SPRINT; blood pressure control; glucose; hypertension.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Blood Glucose / metabolism*
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / prevention & control*
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / metabolism
  • Male
  • Middle Aged
  • Risk Factors

Substances

  • Antihypertensive Agents
  • Blood Glucose