Clinical Outcomes by Race and Ethnicity in the Systolic Blood Pressure Intervention Trial (SPRINT): A Randomized Clinical Trial
Author
Still, Carolyn H.; Rodriguez, Carlos J.; Wright, Jackson T. Jr; Craven, Timothy E.; Bress, Adam P.; Chertow, Glenn M.; Whelton, Paul K.; Whittle, Jeffrey C.; Freedman, Barry I.; Johnson, Karen C.; Foy, Capri G.; He, Jiang; Kostis, John B.; Lash, James P.; Pedley, Carolyn F.; Pisoni, Roberto; Powell, James R.; Wall, Barry M.
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.
Date
2017-08-23
Citation:
APA:
Still, Carolyn H., & Rodriguez, Carlos J., & Wright, Jackson T. Jr, & Craven, Timothy E., & Bress, Adam P., & Chertow, Glenn M., & Whelton, Paul K., & Whittle, Jeffrey C., & Freedman, Barry I., & Johnson, Karen C., & Foy, Capri G., & He, Jiang, & Kostis, John B., & Lash, James P., & Pedley, Carolyn F., & Pisoni, Roberto, & Powell, James R., & Wall, Barry M.. (August 2017).
Clinical Outcomes by Race and Ethnicity in the Systolic Blood Pressure Intervention Trial (SPRINT): A Randomized Clinical Trial.
,
(),
-
. Retrieved from
http://hdl.handle.net/10342/8443
MLA:
Still, Carolyn H., and Rodriguez, Carlos J., and Wright, Jackson T. Jr, and Craven, Timothy E., and Bress, Adam P., and Chertow, Glenn M., and Whelton, Paul K., and Whittle, Jeffrey C., and Freedman, Barry I., and Johnson, Karen C., and Foy, Capri G., and He, Jiang, and Kostis, John B., and Lash, James P., and Pedley, Carolyn F., and Pisoni, Roberto, and Powell, James R., and Wall, Barry M..
"Clinical Outcomes by Race and Ethnicity in the Systolic Blood Pressure Intervention Trial (SPRINT): A Randomized Clinical Trial". .
. (),
August 2017.
October 01, 2023.
http://hdl.handle.net/10342/8443.
Chicago:
Still, Carolyn H. and Rodriguez, Carlos J. and Wright, Jackson T. Jr and Craven, Timothy E. and Bress, Adam P. and Chertow, Glenn M. and Whelton, Paul K. and Whittle, Jeffrey C. and Freedman, Barry I. and Johnson, Karen C. and Foy, Capri G. and He, Jiang and Kostis, John B. and Lash, James P. and Pedley, Carolyn F. and Pisoni, Roberto and Powell, James R. and Wall, Barry M.,
"Clinical Outcomes by Race and Ethnicity in the Systolic Blood Pressure Intervention Trial (SPRINT): A Randomized Clinical Trial," , no.
(August 2017),
http://hdl.handle.net/10342/8443 (accessed
October 01, 2023).
AMA:
Still, Carolyn H., Rodriguez, Carlos J., Wright, Jackson T. Jr, Craven, Timothy E., Bress, Adam P., Chertow, Glenn M., Whelton, Paul K., Whittle, Jeffrey C., Freedman, Barry I., Johnson, Karen C., Foy, Capri G., He, Jiang, Kostis, John B., Lash, James P., Pedley, Carolyn F., Pisoni, Roberto, Powell, James R., Wall, Barry M..
Clinical Outcomes by Race and Ethnicity in the Systolic Blood Pressure Intervention Trial (SPRINT): A Randomized Clinical Trial. .
August 2017;
():
.
http://hdl.handle.net/10342/8443. Accessed
October 01, 2023.
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