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Intensive Blood Pressure Treatment Reduced Stroke Risk in Patients With Albuminuria in the SPRINT Trial

2019Journal article Open access
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dc.contributor.authorLeitão, L
dc.contributor.authorSoares-Dos-Reis, R
dc.contributor.authorNeves, JS
dc.contributor.authorBaptista, RB
dc.contributor.authorBigotte Vieira, M
dc.contributor.authorMc Causland, FR
dc.date.accessioned2021-01-22T16:21:06Z
dc.date.available2021-01-22T16:21:06Z
dc.date.issued2019
dc.description.abstractBackground and Purpose- Albuminuria is associated with stroke risk among individuals with diabetes. However, the association of albuminuria with incident stroke among nondiabetic patients is less clear. Methods- We performed a post hoc analysis of the SPRINT (Systolic Blood Pressure Intervention Trial), which examined the effect of higher versus lower intensity blood pressure management on mortality in 8913 participants without diabetes. We fit unadjusted and adjusted Cox proportional hazards models to estimate the association of baseline albuminuria (urinary albumin-to-creatinine ratio ≥30 mg/g versus<30 mg/g) with stroke risk. We also assessed effect modification according to treatment arms. Results- Mean age was 68±9 years, 35% were female, and 30% were black. Median follow-up was 3.2 years, and 19% patients had baseline albuminuria. Incident stroke occurred in 129 individuals during follow-up. Albuminuria was associated with increased stroke risk (unadjusted hazard ratio, 2.24; 95% CI, 1.55-3.23; adjusted hazard ratio 1.73; 95% CI, 1.17-2.56). The association of albuminuria with incident stroke differed according to the randomized treatment arm (P interaction=0.03). In the intensive treatment arm, the association of albuminuria and stroke was nonsignificant (unadjusted hazard ratio, 1.25; 95% CI, 0.69-2.28), whereas, in the standard treatment arm, it was significant (unadjusted hazard ratio, 3.44; 95% CI, 2.11-5.61). Conclusions- In a post hoc analysis of SPRINT, baseline albuminuria (versus not) was associated with a higher risk of incident stroke, but this relationship appeared to be restricted to those in the standard treatment arm. Further studies are required to conclusively determine if reduction of albuminuria in itself is beneficial in reducing stroke risk. Clinical Trial Registration- URL: https://www.clinicaltrials.gov. Unique identifier: NCT01206062.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationStroke . 2019 Dec;50(12):3639-3642pt_PT
dc.identifier.doi10.1161/STROKEAHA.119.026316pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3544
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherAmerican Heart Associsationpt_PT
dc.subjectAcute Coronary Syndromept_PT
dc.subjectAgedpt_PT
dc.subjectAlbuminuriapt_PT
dc.subjectAntihypertensive Agentspt_PT
dc.subjectCardiovascular Diseasespt_PT
dc.subjectFemalept_PT
dc.subjectHeart Failurept_PT
dc.subjectHumanspt_PT
dc.subjectHypertensionpt_PT
dc.subjectIncidencept_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectMyocardial Infarctionpt_PT
dc.subjectPatient Care Planningpt_PT
dc.subjectProportional Hazards Modelspt_PT
dc.subjectRandomized Controlled Trials as Topicpt_PT
dc.subjectRiskpt_PT
dc.subjectStrokept_PT
dc.subjectHCC NEFpt_PT
dc.subjectHSJ NEUpt_PT
dc.subjectHDE PEDpt_PT
dc.titleIntensive Blood Pressure Treatment Reduced Stroke Risk in Patients With Albuminuria in the SPRINT Trialpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage3642pt_PT
oaire.citation.issue12pt_PT
oaire.citation.startPage3639pt_PT
oaire.citation.titleStrokept_PT
oaire.citation.volume50pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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