Effect of intensiveversus standard blood pressure treatment according to baseline prediabetes status

A post hoc analysis of a randomized trial

Adam P. Bress, Jordan B. King, Kathryn E. Kreider, Srinivasan Beddhu, Debra L. Simmons, Alfred K. Cheung, Yingying Zhang, Michael Doumas, John Nord, Mary Ellen Sweeney, Addison A. Taylor, Charles Herring, William J. Kostis, James Powell, Anjay Rastogi, Christianne L. Roumie, Alan Wiggers, Jonathan S. Williams, Reem Yunis, Athena Zias & 7 others Greg W. Evans, Tom Greene, Michael V. Rocco, William Cushman, David M. Reboussin, Mark N. Feinglos, Vasilios Papademetriou

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE To determine whether the effects of intensive (<120 mmHg) compared with standard (<140 mmHg) systolic blood pressure (SBP) treatment are different among those with prediabetes versus those with fasting normoglycemia at baseline in the Systolic Blood Pressure Intervention Trial (SPRINT). RESEARCH DESIGN AND METHODS This was a post hoc analysis of SPRINT. SPRINT participants were categorized by prediabetes status, defined as baseline fasting serum glucose ≥100 mg/dL versus those with normoglycemia (fasting serum glucose <100 mg/dL). The primary outcome was a composite ofmyocardial infarction, acute coronary syndrome not resulting in myocardial infarction, stroke, acute decompensated heart failure, or death from cardiovascular causes. Cox regression was used to calculate hazard ratios for study outcomeswith intensive compared with standard SBP treatment among those with prediabetes and normoglycemia. RESULTS Among 9,361 participants randomized (age 67.9 ± 9.4 years; 35.5% female), 3,898 and 5,425 had baseline prediabetes and normoglycemia, respectively. After amedian follow-up of 3.26 years, the hazard ratio for the primary outcome was 0.69 (95% CI 0.53, 0.89) and 0.83 (95% CI 0.66, 1.03) among those with prediabetes and normoglycemia, respectively (P value for interaction 0.30). For all-cause mortality, the hazard ratio with intensive SBP treatment was 0.77 (95% CI 0.55, 1.06) for prediabetes and 0.71 (95% CI 0.54, 0.94) for normoglycemia (P value for interaction 0.74). Effects of intensive versus standard SBP treatment on prespecified renal outcomes and serious adverse events were similar for prediabetes and normoglycemia (all interaction P > 0.05). CONCLUSIONS In SPRINT, the beneficial effects of intensive SBP treatment were similar among those with prediabetes and fasting normoglycemia.

Original languageEnglish (US)
Pages (from-to)1401-1408
Number of pages8
JournalDiabetes care
Volume40
Issue number10
DOIs
StatePublished - Oct 1 2017

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Prediabetic State
Fasting
Blood Pressure

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Bress, A. P., King, J. B., Kreider, K. E., Beddhu, S., Simmons, D. L., Cheung, A. K., ... Papademetriou, V. (2017). Effect of intensiveversus standard blood pressure treatment according to baseline prediabetes status: A post hoc analysis of a randomized trial. Diabetes care, 40(10), 1401-1408. https://doi.org/10.2337/dc17-0885

Effect of intensiveversus standard blood pressure treatment according to baseline prediabetes status : A post hoc analysis of a randomized trial. / Bress, Adam P.; King, Jordan B.; Kreider, Kathryn E.; Beddhu, Srinivasan; Simmons, Debra L.; Cheung, Alfred K.; Zhang, Yingying; Doumas, Michael; Nord, John; Sweeney, Mary Ellen; Taylor, Addison A.; Herring, Charles; Kostis, William J.; Powell, James; Rastogi, Anjay; Roumie, Christianne L.; Wiggers, Alan; Williams, Jonathan S.; Yunis, Reem; Zias, Athena; Evans, Greg W.; Greene, Tom; Rocco, Michael V.; Cushman, William; Reboussin, David M.; Feinglos, Mark N.; Papademetriou, Vasilios.

In: Diabetes care, Vol. 40, No. 10, 01.10.2017, p. 1401-1408.

Research output: Contribution to journalArticle

Bress, AP, King, JB, Kreider, KE, Beddhu, S, Simmons, DL, Cheung, AK, Zhang, Y, Doumas, M, Nord, J, Sweeney, ME, Taylor, AA, Herring, C, Kostis, WJ, Powell, J, Rastogi, A, Roumie, CL, Wiggers, A, Williams, JS, Yunis, R, Zias, A, Evans, GW, Greene, T, Rocco, MV, Cushman, W, Reboussin, DM, Feinglos, MN & Papademetriou, V 2017, 'Effect of intensiveversus standard blood pressure treatment according to baseline prediabetes status: A post hoc analysis of a randomized trial', Diabetes care, vol. 40, no. 10, pp. 1401-1408. https://doi.org/10.2337/dc17-0885
Bress, Adam P. ; King, Jordan B. ; Kreider, Kathryn E. ; Beddhu, Srinivasan ; Simmons, Debra L. ; Cheung, Alfred K. ; Zhang, Yingying ; Doumas, Michael ; Nord, John ; Sweeney, Mary Ellen ; Taylor, Addison A. ; Herring, Charles ; Kostis, William J. ; Powell, James ; Rastogi, Anjay ; Roumie, Christianne L. ; Wiggers, Alan ; Williams, Jonathan S. ; Yunis, Reem ; Zias, Athena ; Evans, Greg W. ; Greene, Tom ; Rocco, Michael V. ; Cushman, William ; Reboussin, David M. ; Feinglos, Mark N. ; Papademetriou, Vasilios. / Effect of intensiveversus standard blood pressure treatment according to baseline prediabetes status : A post hoc analysis of a randomized trial. In: Diabetes care. 2017 ; Vol. 40, No. 10. pp. 1401-1408.
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abstract = "OBJECTIVE To determine whether the effects of intensive (<120 mmHg) compared with standard (<140 mmHg) systolic blood pressure (SBP) treatment are different among those with prediabetes versus those with fasting normoglycemia at baseline in the Systolic Blood Pressure Intervention Trial (SPRINT). RESEARCH DESIGN AND METHODS This was a post hoc analysis of SPRINT. SPRINT participants were categorized by prediabetes status, defined as baseline fasting serum glucose ≥100 mg/dL versus those with normoglycemia (fasting serum glucose <100 mg/dL). The primary outcome was a composite ofmyocardial infarction, acute coronary syndrome not resulting in myocardial infarction, stroke, acute decompensated heart failure, or death from cardiovascular causes. Cox regression was used to calculate hazard ratios for study outcomeswith intensive compared with standard SBP treatment among those with prediabetes and normoglycemia. RESULTS Among 9,361 participants randomized (age 67.9 ± 9.4 years; 35.5{\%} female), 3,898 and 5,425 had baseline prediabetes and normoglycemia, respectively. After amedian follow-up of 3.26 years, the hazard ratio for the primary outcome was 0.69 (95{\%} CI 0.53, 0.89) and 0.83 (95{\%} CI 0.66, 1.03) among those with prediabetes and normoglycemia, respectively (P value for interaction 0.30). For all-cause mortality, the hazard ratio with intensive SBP treatment was 0.77 (95{\%} CI 0.55, 1.06) for prediabetes and 0.71 (95{\%} CI 0.54, 0.94) for normoglycemia (P value for interaction 0.74). Effects of intensive versus standard SBP treatment on prespecified renal outcomes and serious adverse events were similar for prediabetes and normoglycemia (all interaction P > 0.05). CONCLUSIONS In SPRINT, the beneficial effects of intensive SBP treatment were similar among those with prediabetes and fasting normoglycemia.",
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T1 - Effect of intensiveversus standard blood pressure treatment according to baseline prediabetes status

T2 - A post hoc analysis of a randomized trial

AU - Bress, Adam P.

AU - King, Jordan B.

AU - Kreider, Kathryn E.

AU - Beddhu, Srinivasan

AU - Simmons, Debra L.

AU - Cheung, Alfred K.

AU - Zhang, Yingying

AU - Doumas, Michael

AU - Nord, John

AU - Sweeney, Mary Ellen

AU - Taylor, Addison A.

AU - Herring, Charles

AU - Kostis, William J.

AU - Powell, James

AU - Rastogi, Anjay

AU - Roumie, Christianne L.

AU - Wiggers, Alan

AU - Williams, Jonathan S.

AU - Yunis, Reem

AU - Zias, Athena

AU - Evans, Greg W.

AU - Greene, Tom

AU - Rocco, Michael V.

AU - Cushman, William

AU - Reboussin, David M.

AU - Feinglos, Mark N.

AU - Papademetriou, Vasilios

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N2 - OBJECTIVE To determine whether the effects of intensive (<120 mmHg) compared with standard (<140 mmHg) systolic blood pressure (SBP) treatment are different among those with prediabetes versus those with fasting normoglycemia at baseline in the Systolic Blood Pressure Intervention Trial (SPRINT). RESEARCH DESIGN AND METHODS This was a post hoc analysis of SPRINT. SPRINT participants were categorized by prediabetes status, defined as baseline fasting serum glucose ≥100 mg/dL versus those with normoglycemia (fasting serum glucose <100 mg/dL). The primary outcome was a composite ofmyocardial infarction, acute coronary syndrome not resulting in myocardial infarction, stroke, acute decompensated heart failure, or death from cardiovascular causes. Cox regression was used to calculate hazard ratios for study outcomeswith intensive compared with standard SBP treatment among those with prediabetes and normoglycemia. RESULTS Among 9,361 participants randomized (age 67.9 ± 9.4 years; 35.5% female), 3,898 and 5,425 had baseline prediabetes and normoglycemia, respectively. After amedian follow-up of 3.26 years, the hazard ratio for the primary outcome was 0.69 (95% CI 0.53, 0.89) and 0.83 (95% CI 0.66, 1.03) among those with prediabetes and normoglycemia, respectively (P value for interaction 0.30). For all-cause mortality, the hazard ratio with intensive SBP treatment was 0.77 (95% CI 0.55, 1.06) for prediabetes and 0.71 (95% CI 0.54, 0.94) for normoglycemia (P value for interaction 0.74). Effects of intensive versus standard SBP treatment on prespecified renal outcomes and serious adverse events were similar for prediabetes and normoglycemia (all interaction P > 0.05). CONCLUSIONS In SPRINT, the beneficial effects of intensive SBP treatment were similar among those with prediabetes and fasting normoglycemia.

AB - OBJECTIVE To determine whether the effects of intensive (<120 mmHg) compared with standard (<140 mmHg) systolic blood pressure (SBP) treatment are different among those with prediabetes versus those with fasting normoglycemia at baseline in the Systolic Blood Pressure Intervention Trial (SPRINT). RESEARCH DESIGN AND METHODS This was a post hoc analysis of SPRINT. SPRINT participants were categorized by prediabetes status, defined as baseline fasting serum glucose ≥100 mg/dL versus those with normoglycemia (fasting serum glucose <100 mg/dL). The primary outcome was a composite ofmyocardial infarction, acute coronary syndrome not resulting in myocardial infarction, stroke, acute decompensated heart failure, or death from cardiovascular causes. Cox regression was used to calculate hazard ratios for study outcomeswith intensive compared with standard SBP treatment among those with prediabetes and normoglycemia. RESULTS Among 9,361 participants randomized (age 67.9 ± 9.4 years; 35.5% female), 3,898 and 5,425 had baseline prediabetes and normoglycemia, respectively. After amedian follow-up of 3.26 years, the hazard ratio for the primary outcome was 0.69 (95% CI 0.53, 0.89) and 0.83 (95% CI 0.66, 1.03) among those with prediabetes and normoglycemia, respectively (P value for interaction 0.30). For all-cause mortality, the hazard ratio with intensive SBP treatment was 0.77 (95% CI 0.55, 1.06) for prediabetes and 0.71 (95% CI 0.54, 0.94) for normoglycemia (P value for interaction 0.74). Effects of intensive versus standard SBP treatment on prespecified renal outcomes and serious adverse events were similar for prediabetes and normoglycemia (all interaction P > 0.05). CONCLUSIONS In SPRINT, the beneficial effects of intensive SBP treatment were similar among those with prediabetes and fasting normoglycemia.

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