Cardiometabolic & kidneySecondary analysis
Intensive systolic blood pressure control in patients with or without worsening renal function
- Secondary analysis of the SPRINT randomised trial
- post hoc analysis
- time-updated Cox proportional hazard models
Authors' conclusion
Intensive BP treatment increased the risk of WRF compared with standard BP treatment. However, intensive BP treatment was associated with reduced risks of CVD and all-cause mortality compared with standard BP treatment in patients experiencing WRF, without increasing adverse events.
Study context
- Population
- SPRINT participants, by worsening renal function (eGFR decline ≥30% from baseline during follow-up)1,310 (14.2%) with worsening renal function (WRF)
- Participants
- 9,211 participants
- Comparison
- Intensive vs standard blood pressure (BP) treatment, in patients with and without WRF
- Primary endpoint
- Primary outcome (SPRINT)
Primary result
As reported in the abstract
Primary outcome, by WRF (subgroup)
Intensive BP treatment vs Standard BP treatmentHazard ratio (95% CI)
with WRF
0.54(0.32–0.90)
without WRF
0.82(0.68–0.98)
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| All-cause death, by WRF (subgroup) — Intensive BP treatment vs Standard BP treatment · with WRF | 0.40 (0.23–0.68) | |
| All-cause death, by WRF (subgroup) — Intensive BP treatment vs Standard BP treatment · without WRF | 0.84 (0.67–1.07) | |
| 0.20.5125Hazard ratio (log scale) |
- All-cause death, by WRF (subgroup): interaction P = 0.046
Early vs late WRF
- Results similar among participants with early or late WRF
Safety
Safety events, by WRF
- Risks of safety events similar between BP treatment groups with and without WRF
Original publication
Intensive systolic blood pressure control in patients with or without worsening renal function. Eur J Prev Cardiol. Published 8 April 2025. doi:10.1093/eurjpc/zwaf184
Summarised from the published abstract; every number is checked against it