Systolic BP Targets Not Affected by Race, Ethnicity

Systolic blood pressure (SBP) targets below 120 mmHg are associated with cardiovascular (CV) benefits regardless of race or ethnic origin, compared with targets below 140 mmHg, according to a recent study.

Findings were presented on September 15, 2017, at the American Heart Association (AHA) Council on Hypertension, AHA Council on Kidney in Cardiovascular Disease, American Society of Hypertension Joint Scientific Sessions 2017 in San Francisco, California.
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It has been established that lowering SBP is associated with a lower risk of cardiovascular disease (CVD) morbidity and mortality. However, appropriate SBP targets, especially by race or ethnicity, are still uncertain.

For their study, the researchers analyzed data obtained in the Systolic Blood Pressure Intervention Trial (SPRINT), and compared the effects of an intensive SBP target below 120 mmHg vs a standard target below 140 mmHg in 9361 high-risk patients with hypertension without diabetes. Patients were age 50 years or older. A total of 30% of patients were black, and 11% were Hispanic.

The primary outcome was defined as a composite of the first occurrence of a myocardial infarction (MI), acute coronary syndrome (ACS), stroke, decompensated heart failure, or CVD death.

Ultimately, the researchers found that an SBP target below 120 mmHg was associated with cardiovascular benefits, regardless of racial/ethnic origin. The average post-baseline SBP across racial/ethnic groups had ranged from 134.7 mmHg to 135.5 mmHg in the standard arm vs 119.9 mmHg to 122.6 mmHg in the intensive arm.

Hazard ratios (HRs) for the primary outcome in the intensive arm vs the standard arm were 0.70 (non-Hispanic whites), 0.71 (non-Hispanic blacks), and 0.62 (Hispanics). Additionally, CVD mortality HRs were 0.49 (non-Hispanic whites), 0.77 (non-Hispanic blacks), and 0.17 (Hispanics), and all-cause mortality HRs were 0.61 (non-Hispanic whites), 0.92 (non-Hispanic blacks), and 1.58 (Hispanics).

“Regardless of racial/ethnic origin, there are cardiovascular benefits from treating to a SBP target of [less than] 120 mmHg compared to [less than] 140 mmHg.”

—Christina Vogt

Reference:

Still CH, Rodriguez CJ, Wright Jr JT, et al. Clinical outcomes by race and ethnicity in the systolic blood pressure intervention trials (SPRINT): a randomized controlled trial. Paper presented at: American Heart Association (AHA) Council on Hypertension, AHA Council on Kidney in Cardiovascular Disease, American Society of Hypertension Joint Scientific Sessions 2017; September 14-17, 2017. San Francisco, CA. http://www.abstractsonline.com/pp8/ - !/4472/presentation/3512.