Background: Intensive blood pressure management is associated with decreased overall incidence of myocardial infarction, stroke and hospitalization for heart failure among non-diabetic patients though with several associated adverse events (SAEs). The present study aimed to identify patients who are at increased risk of having adverse events while on the intensive blood pressure therapy.
Methods: Data from the SPRINT trial was analyzed. Study participants who were in the intensive arm of the trial were divided into two groups based on the outcome of SAEs as defined per trial protocol. Baseline characteristics of the patients in both groups were compared using chi-square analysis. Logistic regression models were used to determine factors associated with developing a SAE while on the intensive therapy.
Results: Out of 4678 patients who received intensive therapy, 1684 (36.0%) were females. The mean ± SD age was 67.9 +/- 9.4 years. The incidence of SAEs was 38.3% (n=1793). On multivariable analysis, factors associated with developing a SAE were found to Age (OR per unit change 1.04, 95% CI: 1.03-1.05 p-value: <0.001), Creatinine (OR/unit change 1.59, 95% CI: 1.12-2.26 p-value: 0.0094), Smoking (1.50, 95% 1.22-1.85, p-value:0.0001), BMI (OR/unit change 1.03,95% CI 1.02-1.04 p-value <0.001), urine microalbumin (numbers?) and the more medications the increased the risk of adverse outcomes.
Conclusion: Intensive blood pressure management is associated with improved cardiovascular outcomes, however factors such as older age,high creatinine levels and a positive history of smoking are associated with developing serious adverse events. .