ArticleThe American journal of medicine2018
Optimal Systolic Blood Pressure Target in Resistant and Non-Resistant Hypertension: A Pooled Analysis of Patient-Level Data from SPRINT and ACCORD.
Article in The American journal of medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 17 citations in OpenAlex.
- Gender Difference of Blood Pressure Control Rate and Clinical Prognosis in Patients With Resistant Hypertension: Real-World Observation Study.Journal of Korean medical science · 2023Article
- 2022 Guidelines of the Taiwan Society of Cardiology and the Taiwan Hypertension Society for the Management of Hypertension.Acta Cardiologica Sinica · 2022Article
- The Burden of Resistant Hypertension Across the World.Current hypertension reports · 2022Review
- Office blood pressure threshold of 130/80 mmHg better predicts uncontrolled out-of-office blood pressure in apparent treatment-resistant hypertension.Journal of clinical hypertension (Greenwich, Conn.) · 2021Observational
- Redefining Resistant Hypertension: A Comparison of Cardiovascular Risk Associated With the 2018 Versus 2008 American Heart Association Definitions for Resistant Hypertension.Circulation. Cardiovascular quality and outcomes · 2020Article
- Approaches for the Management of Resistant Hypertension in 2020.Current hypertension reports · 2020Review
- Blood Pressure Control and Protection of the Aging Brain.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2019Review
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundPrior studies suggest benefits of blood pressure lowering on cardiovascular risk may be attenuated in patients with resistant hypertension compared with the general hypertensive population, but prospective data are lacking.
methodsWe assessed intensive (<120 mm Hg) versus standard (<140 mm Hg) systolic blood pressure targets on adverse outcome risk according to baseline resistant hypertension status, using Action to Control Cardiovascular Risk in Diabetes (ACCORD) and Systolic Blood Pressure Intervention Trial (SPRINT) patient-level data. Patients were categorized as having baseline apparent resistant hypertension (blood pressure ≥130/80 mm Hg while using 3 antihypertensive drugs or use of ≥4 drugs regardless of blood pressure) or non-resistant hypertension (all others). Cox regression was used to assess effects of treatment assignment, resistant hypertension status, their interaction, and other covariates, on first occurrence of 2 outcomes: myocardial infarction, stroke, cardiovascular death ± heart failure, and the same outcomes plus all-cause death, individually.
resultsAmong 14,094 patients, 2710 (19.2%) had baseline apparent resistant hypertension. In adjusted models, an intensive target reduced risk of both outcomes (myocardial infarction/stroke/cardiovascular death: hazard ratio [HR], 0.81; 95% confidence interval [CI], 0.71-0.93; myocardial infarction/stroke/heart failure/cardiovascular death: HR 0.78; 95% CI, 0.69-0.88) as well as stroke (HR 0.72; 95% CI, 0.55-0.94) and heart failure (HR 0.73; 95% CI, 0.59-0.91). An intensive target also appeared to reduce myocardial infarction, cardiovascular death, and all-cause death risk. Benefits were observed irrespective of baseline resistant hypertension status.
conclusionsOur findings provide the first evidence to support guidance to treat resistant hypertension to the same blood pressure goal as non-resistant hypertension.
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