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Clinical Outcomes by Race and Ethnicity in the Systolic Blood Pressure Intervention Trial (SPRINT): A Randomized Clinical Trial
- Source :
- American Journal of Hypertension
- Publication Year :
- 2017
- Publisher :
- Oxford University Press (OUP), 2017.
-
Abstract
- BACKGROUND The Systolic Blood Pressure Intervention Trial (SPRINT) showed that targeting a systolic blood pressure (SBP) of ≤ 120 mm Hg (intensive treatment) reduced cardiovascular disease (CVD) events compared to SBP of ≤ 140 mm Hg (standard treatment); however, it is unclear if this effect is similar in all racial/ethnic groups. METHODS We analyzed SPRINT data within non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic subgroups to address this question. High-risk nondiabetic hypertensive patients (N = 9,361; 30% NHB; 11% Hispanic) 50 years and older were randomly assigned to intensive or standard treatment. Primary outcome was a composite of the first occurrence of a myocardial infarction, acute coronary syndrome, stroke, decompensated heart failure, or CVD death. RESULTS Average postbaseline SBP was similar among NHW, NHB, and Hispanics in both treatment arms. Hazard ratios (HRs) (95% confidence interval) (intensive vs. standard treatment groups) for primary outcome were 0.70 (0.57–0.86), 0.71 (0.51–0.98), 0.62 (0.33–1.15) (interaction P value = 0.85) in NHW, NHB, and Hispanics. CVD mortality HRs were 0.49 (0.29–0.81), 0.77 (0.37–1.57), and 0.17 (0.01–1.08). All-cause mortality HRs were 0.61 (0.47–0.80), 0.92 (0.63–1.35), and 1.58 (0.73–3.62), respectively. A test for differences among racial/ethnic groups in the effect of treatment assignment on all-cause mortality was not significant (Hommel-adjusted P value = 0.062) after adjustment for multiple comparisons. CONCLUSION Targeting a SBP goal of ≤ 120 mm Hg compared to ≤ 140 mm Hg led to similar SBP control and was associated with similar benefits and risks among all racial ethnic groups, though NHBs required an average of ~0.3 more medications. CLINICAL TRIALS REGISTRATION Trial Number NCT01206062, ClinicalTrials.gov Identifier at https://clinicaltrials.gov/ct2/show/NCT01206062.
- Subjects :
- Male
Original Contributions
Hispanics
Myocardial Infarction
Blood Pressure
race and ethnicity
030204 cardiovascular system & hematology
law.invention
0302 clinical medicine
Randomized controlled trial
law
Ethnicity
030212 general & internal medicine
Myocardial infarction
Stroke
Aged, 80 and over
African Americans
Standard treatment
Hazard ratio
Hispanic or Latino
Middle Aged
clinical outcomes
3. Good health
Treatment Outcome
Female
Acute coronary syndrome
medicine.medical_specialty
hypertension
Systole
Black People
White People
03 medical and health sciences
Internal medicine
Internal Medicine
medicine
Humans
Acute Coronary Syndrome
Antihypertensive Agents
Aged
Heart Failure
clinical trials
business.industry
Racial Groups
medicine.disease
Confidence interval
Editor's Choice
Blood pressure
Socioeconomic Factors
business
Subjects
Details
- ISSN :
- 19417225 and 08957061
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- American Journal of Hypertension
- Accession number :
- edsair.doi.dedup.....29b500fe5882819c0d6f0ddeedcd4ef4