Prevention of heart failure events with intensive versus standard blood pressure lowering across the spectrum of kidney function and albuminuria: a SPRINT substudy
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Prevention of heart failure events with intensive versus standard blood pressure lowering across the spectrum of kidney function and albuminuria : a SPRINT substudy. / Vaduganathan, Muthiah; Pareek, Manan; Kristensen, Anna M. D.; Biering-Sorensen, Tor; Byrne, Christina; Almarzooq, Zaid; Olesen, Thomas Bastholm; Olsen, Michael H.; Bhatt, Deepak L.
I: European Journal of Heart Failure, Bind 23, Nr. 3, 2021, s. 384-392.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Prevention of heart failure events with intensive versus standard blood pressure lowering across the spectrum of kidney function and albuminuria
T2 - a SPRINT substudy
AU - Vaduganathan, Muthiah
AU - Pareek, Manan
AU - Kristensen, Anna M. D.
AU - Biering-Sorensen, Tor
AU - Byrne, Christina
AU - Almarzooq, Zaid
AU - Olesen, Thomas Bastholm
AU - Olsen, Michael H.
AU - Bhatt, Deepak L.
PY - 2021
Y1 - 2021
N2 - Aims To determine whether a strategy of intensive blood pressure control reduces the risk of heart failure (HF) events consistently across the spectrum of kidney function and albuminuria. Methods and results SPRINT was a randomized clinical trial in which 9361 individuals >= 50 years, at high risk for or with cardiovascular disease, a systolic blood pressure of 130-180 mmHg, but without diabetes, were randomized to intensive (target 300 mg/g. During a median follow-up of 3.2 years (range 0-4.8 years), 160 (1.8%) participants had HF events and 233 (2.6%) had HF events or cardiovascular death. Risks of HF events or cardiovascular death increased from 0.42 (0.34-0.53) per 100 patient-years in patients with eGFR >= 60 mL/min/1.73 m(2)and UACR 0.05). Conclusion In SPRINT, eGFR and albuminuria were strong and additive determinants in forecasting HF risk. The effect of intensive blood pressure control in decreasing HF risk did not significantly vary across the spectrum of kidney function or albuminuria. Multidisciplinary pathways, incorporating blood pressure control, are needed for at-risk patients with chronic kidney disease to attenuate HF risk. Trial Registration: Identifier NCT01206062.
AB - Aims To determine whether a strategy of intensive blood pressure control reduces the risk of heart failure (HF) events consistently across the spectrum of kidney function and albuminuria. Methods and results SPRINT was a randomized clinical trial in which 9361 individuals >= 50 years, at high risk for or with cardiovascular disease, a systolic blood pressure of 130-180 mmHg, but without diabetes, were randomized to intensive (target 300 mg/g. During a median follow-up of 3.2 years (range 0-4.8 years), 160 (1.8%) participants had HF events and 233 (2.6%) had HF events or cardiovascular death. Risks of HF events or cardiovascular death increased from 0.42 (0.34-0.53) per 100 patient-years in patients with eGFR >= 60 mL/min/1.73 m(2)and UACR 0.05). Conclusion In SPRINT, eGFR and albuminuria were strong and additive determinants in forecasting HF risk. The effect of intensive blood pressure control in decreasing HF risk did not significantly vary across the spectrum of kidney function or albuminuria. Multidisciplinary pathways, incorporating blood pressure control, are needed for at-risk patients with chronic kidney disease to attenuate HF risk. Trial Registration: Identifier NCT01206062.
KW - Albuminuria
KW - Blood pressure
KW - Chronic kidney disease
KW - Heart failure
KW - Hypertension
KW - GLOMERULAR-FILTRATION-RATE
KW - CARDIOVASCULAR OUTCOMES
KW - DISEASE
KW - RISK
KW - ASSOCIATION
KW - TRIAL
U2 - 10.1002/ejhf.1971
DO - 10.1002/ejhf.1971
M3 - Journal article
C2 - 33448580
VL - 23
SP - 384
EP - 392
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
SN - 1567-4215
IS - 3
ER -
ID: 247938118