Logo image
Back
Blood pressure variability predicts adverse events and cardiovascular outcomes in SPRINT
Journal article   Open access   Peer reviewed

Blood pressure variability predicts adverse events and cardiovascular outcomes in SPRINT

Kenechukwu Mezue, Abhinav Goyal, Gregg S Pressman, Roy Matthew, Jay C Horrow and Janani Rangaswami
The journal of clinical hypertension (Greenwich, Conn.), v 20(9), pp 1247-1252
Sep 2018
DOI: https://doi.org/10.1111/jch.13346
PMID: 29984884
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1111/jch.13346View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

Acute Kidney Injury - etiology Antihypertensive Agents - therapeutic use Blood Pressure - physiology Blood Pressure Determination Cardiovascular Diseases - etiology Female Humans Hypertension - complications Hypertension - drug therapy Male Regression Analysis Risk Factors
SPRINT (Systolic Blood Pressure Intervention Trial) highlighted the benefits of intensive targeted antihypertensive therapy but resulted in higher rates of treatment-related adverse events. Blood pressure (BP) variability has emerged as a significant predictor of outcomes over and above levels of BP. Using the SPRINT data set, we aimed to determine the relationship of BP variability with cardiovascular outcomes and side effects of antihypertensive therapy. The analyses included all participants randomized in SPRINT who reached the target systolic BP (SBP) for their respective groups (intensive < 120 mm Hg; standard < 140 mm Hg). Coefficients of variation (CV) for SBP, diastolic BP (DBP), and PP for each patient characterized variability. Student t test was used to compare treatment arms for each CV metric. Cox proportional hazards regression was used to identify independent predictors of the SPRINT primary outcome and adverse events. P < .15 on univariate analysis was required to enter the model and P < .05 to remain in it. A total of 8884 patients (4561 standard group; 4323 intensive group) met inclusion criteria. DBP CV differed between the groups (9.12 ± 3.20 standard group; 9.47 ± 3.49 intensive group [P < .0001]). DBP CV predicted a greater hazard for the primary outcome (hazard ratio [HR], 1.14) in the overall model as well as separate analyses by treatment arms (standard group HR, 1.15; intensive group HR, 1.19), each P < .0001. DBP CV also independently predicted a greater hazard for acute kidney injury (HR, 1.12) and hypotensive events (HR, 1.12). Visit-to-visit DBP variability independently predicted worse cardiovascular outcomes and hypoperfusion-related adverse events in SPRINT.

Metrics

12 Record Views
30 citations in Web of Science
28 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
Web of Science research areas
Peripheral Vascular Disease
Logo image