Blood pressure reduction and anti‐hypertensive treatment choice: A post‐hoc analysis of the <scp>SPRINT</scp> trial

Ferreira, João Pedro; Gregson, John; Böhm, Michael; Rossignol, Patrick; Zannad, Faı̈ez; Pocock, Stuart J.

doi:10.1002/clc.23591

Cited by 3 publications

(1 citation statement)

References 31 publications

(42 reference statements)

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“…This study provides data on the unique class regimens used in SPRINT, which previous studies have not fully detailed. 3,14 We note that in the intensive treatment group at 12 months, participants most commonly used an ACE or ARB and a thiazide diuretic, with or without a CCB; in the standard treatment group, the most common regimens were an ACE or an ARB as monotherapy or as dual-therapy with a thiazide diuretic. These combinations are widely commercially available in the US as generic, fixed-dose combination products, yet less than a third of US adults with pharmacologically treated hypertension are using a fixed-dose combination product.…”

Section: Discussionmentioning

confidence: 99%

Antihypertensive Medication Regimens Used in the Systolic Blood Pressure Intervention Trial

et al. 2023

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BACKGROUND: Describing the antihypertensive medication regimens used in the SPRINT (Systolic Blood Pressure Intervention Trial) would contextualize the standard and intensive systolic blood pressure (SBP) interventions and may inform future implementation efforts to achieve population-wide intensive SBP goals. METHODS: We included SPRINT participants with complete medication data at the prerandomization and 12-month visits. Regimens were categorized by antihypertensive medication class. Analyses were stratified by treatment group (standard goal SBP <140 mm Hg versus intensive goal SBP <120 mm Hg). RESULTS: Among 7860 participants (83.7% of 9361 randomized), the median number of classes used at the prerandomization visit was 2.0 and 2.0 in the standard and intensive groups ( P =0.559). At 12-months, the median number of classes used was 3.0 and 2.0 in the intensive and standard groups ( P <0.001). Prerandomization, angiotensin-converting enzyme inhibitor (ACE), or angiotensin-II receptor blocker (ARB) monotherapy was the most common regimen in the intensive and standard groups (12.6% versus 12.2%). At 12-months, ACE/ARB monotherapy was still the most common regimen among standard group participants (14.7%) and was used by 5.3% of intensive group participants. Multidrug regimens used by the intensive and standard participants at 12 months were as follows: an ACE/ARB with thiazide (12.2% and 7.9%); an ACE/ARB with calcium channel blocker (6.2% and 6.8%); an ACE/ARB, thiazide, and calcium channel blocker (11.4% and 4.3%); and an ACE/ARB, thiazide, calcium channel blocker, and beta-blocker (6.5% and 1.2%). CONCLUSIONS: SPRINT investigators favored combining ACEs or ARBs, thiazide diuretics, and calcium channel blockers to target SBP <120 mm Hg, compared to ACE/ARB monotherapy to target SBP <140 mm Hg. Registration: URL: https://clinicaltrials.gov ; Unique identifier: NCT01206062.

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Section: Discussionmentioning

confidence: 99%

Antihypertensive Medication Regimens Used in the Systolic Blood Pressure Intervention Trial

et al. 2023

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Antihypertensive medication classes and risk of incident dementia in primary care patients: a longitudinal cohort study in the Netherlands

Schroevers,

Hoevenaar-Blom,

Busschers

et al. 2024

The Lancet Regional Health - Europe

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The impact of blood pressure lowering agents on the risk of worsening frailty among patients with diabetes mellitus: a cohort study

Wang,

Lee,

Chao

et al. 2024

npj Aging

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Patients with diabetes mellitus (DM) are at risk of developing frailty, but studies rarely addressed risk factors for frailty worsening. We investigated whether blood pressure (BP)-lowering agents influenced such risk in these patients. Adults with type 2 DM were identified from National Taiwan University Hospital, with the primary outcome, the worsening of frailty by ≧1 score increase of FRAIL scale determined. We used the Cox proportional hazards analysis to derive the risk of worsening frailty associated with BP-lowering agents. Among 41,440 patients with DM, 27.4% developed worsening frailty after 4.09 years of follow-up. Cox regression revealed that diuretics (hazard ratio (HR) 1.12, 95% confidence interval (CI) 1.06–1.18) and α-blocker (HR 1.14, 95% CI 1.06–1.23) users had a significantly higher risk of worsening frailty than non-users, whereas the risk was lower among β-blocker users (HR 0.93, 95% CI 0.88–0.98). It would be therefore prudent to weigh the advantages and disadvantages of using specific BP-lowering agent classes.

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Blood pressure reduction and anti‐hypertensive treatment choice: A post‐hoc analysis of the SPRINT trial

Cited by 3 publications

References 31 publications

Antihypertensive Medication Regimens Used in the Systolic Blood Pressure Intervention Trial

Antihypertensive Medication Regimens Used in the Systolic Blood Pressure Intervention Trial

Antihypertensive medication classes and risk of incident dementia in primary care patients: a longitudinal cohort study in the Netherlands

The impact of blood pressure lowering agents on the risk of worsening frailty among patients with diabetes mellitus: a cohort study

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