Clinical benefit of systolic blood pressure within the target range among patients with or without diabetes mellitus: a propensity score-matched analysis of two randomized clinical trials

• DOI: 10.1186/s12916-022-02407-z
• Publication Date: 2022-06-20T00:02:30Z
• Authors: Chao Li; Kangyu Chen; Guoshuai Shi; Rui Shi; Zhenqiang Wu; Xiaodan Yuan; Vicky Watson; Zhixin Jiang; Hui Mai; Tian Yang; Duolao Wang; Tao Chen
• Keywords: wk_810; Propensity score; Pharmaceutical treatment; Myocardial Infarction; Blood Pressure; wk_20; wg_20; 03 medical and health sciences; Diabetes mellitus; 0302 clinical medicine; Risk Factors; Diabetes Mellitus; Humans; Propensity Score; Antihypertensive Agents; Randomized Controlled Trials as Topic; Heart Failure; R; Cardiovascular disease; 3. Good health; Stroke; Cardiovascular Diseases; Hypertension; Blood pressure; Medicine; Research Article

Recent guidelines recommended a systolic blood pressure (SBP) target of < 130 mmHg for patients with or without diabetes but providing lower bound. Our study aimed to explore whether additional clinical benefits remain at achieved (BP) levels below the target.We performed secondary analysis Systolic Blood Pressure Intervention Trial (SPRINT) among non-diabetic population and Action Control Cardiovascular Risk in Diabetes BP (ACCORD-BP) trial diabetic subjects. We used propensity score method match from intensive group those standard each trial. Individuals different were as "reference." For stratum, trial-specific primary outcome (i.e., composite myocardial infarction (MI), acute coronary syndrome not resulting MI, stroke, decompensated heart failure (HF), cardiovascular death SPRINT; non-fatal ACCORD-BP) was compared by Cox regression.A non-linear association observed between mean incidence events, regardless treatment allocation. The significant benefit remained SBP 110-120 (hazard ratio, 0.59 [95% CI, 0.46, 0.76] 0.67 [0.52, 0.88] 120-130 SPRINT (0.47 [0.34, 0.63]) ACCORD-BP (0.93 [0.70, 1.23]). results similar outcomes including all-cause mortality, HF. Intensive existed maintaining diastolic 60-70 less distinct.The persists low irrespective status. Achieved very appeared increase events mortality.