Intensive BP target reduces LVH rates, increases LVH regression

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Takeaway 

  • Targeting a systolic BP (SBP) of <120 mmHg among patients with hypertension without diabetes is associated with reduced rates of left ventricular hypertrophy (LVH) and increased rates of LVH regression. 

Why this matters  

  • This analysis from the SPRINT trial focuses on LVH, an important marker of end-organ damage and common in hypertension.
  • A previous analysis of data from the ACCORD trial showed benefits of <120 mmHg targets for patients with diabetes and hypertension, they had a reduced risk for LVH as well.  

Study design 

  • Secondary analysis of 8164 participants with hypertension but without diabetes randomly assigned to intensive (target SBP, <120 mmHg) or standard (target SBP, <140 mmHg) BP lowering arms in SPRINT trial.
  • Funding: SPRINT funded by NIH, Department of Veterans Affairs, and others. 

Key results 

  • Median follow-up period was 3.81 y.
  • In participants without baseline LVH (n=7559), intensive vs standard arm was associated with lower risk of developing LVH (HR, 0.54; P<.001).
  • In participants with baseline LVH (n=605), those assigned to intensive arm were more likely to regress vs standard arm (HR, 1.66; P<.001). 

Limitations 

  • Post hoc analysis.
  • Effect of individual medica...