Heart failure and the discrepancy between trials of intensive blood pressure management: an analysis of individual patient data

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
Rahul AggarwalJackson Steinkamp

Abstract

ACCORD and SPRINT are the best randomized controlled trial data evaluating the effects of blood pressure targets below 140 mmHg. These trials had contradictory results regarding the benefits of intensive antihypertensive therapy. We investigate if this discordance was driven by SPRINT's inclusion of Heart Failure in its primary outcome, as this is a parameter not included in ACCORD's original primary outcome. This analysis helps to resolve a significant area of contention. Individual patient data from 4733 participants in ACCORD were analyzed from time of randomization. All participants were diabetic and at increased cardiovascular risk. Participants were assigned to their original intervention, a standard blood pressure target of less than 140 mmHg or an intensive target of less than 120 mmHg. Primary composite outcome was defined as in SPRINT: a composite of first occurrence of myocardial infarction, stroke, heart failure, death from cardiovascular causes, and other acute coronary syndromes. Primary outcome was not significantly different between standard and intensive groups [HR: 0.89; 95% CI: (0.76-1.03); p = 0.108]. The primary composite outcome occurred in 370 participants in the standard group (15.6%) and 324 participant...Continue Reading

References

Feb 2, 2010·Journal of the American College of Cardiology·Thomas G Di SalvoJohn G Byrne
Mar 17, 2010·The New England Journal of Medicine·William C CushmanFaramarz Ismail-Beigi
Aug 21, 2010·Current Hypertension Reports·Matthew R Weir, George L Bakris
Nov 10, 2015·The New England Journal of Medicine·UNKNOWN SPRINT Research GroupWalter T Ambrosius
Nov 10, 2015·The New England Journal of Medicine·Vlado Perkovic, Anthony Rodgers
Nov 11, 2015·Hypertension·William C CushmanUNKNOWN SPRINT Study Research Group
Mar 15, 2016·Cleveland Clinic Journal of Medicine·Edward J Filippone, Andrew J Foy
Jul 1, 2016·American Journal of Hypertension·Lawrence R Krakoff
Jul 15, 2016·Lancet·Yvo M Smulders, Majon Muller
Jul 21, 2016·Journal of the American Society of Hypertension : JASH·Sheldon W Tobe, Joseph L Izzo
Jan 21, 2017·Nature Reviews. Endocrinology·Pantelis A SarafidisLuis M Ruilope
Sep 19, 2017·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Vasiliki BistolaJohn Parissis
Oct 31, 2017·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Matthieu LegrandUNKNOWN GREAT (Global Research on Acute Conditions Team) Network and INI-CRCT (Investigation Network Initiative-Cardiovascular and R

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Citations

Jun 27, 2018·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Kamila LachowskaDagmara Hering

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