Gender, blood pressure, and cardiovascular and renal outcomes in adults with hypertension fromthe Systolic Blood Pressure InterventionTrial

Capri G. Foy, Laura C. Lovato, Mara Z. Vitolins, Jeffrey T. Bates, Ruth Campbell, William C. Cushman, Stephen P. Glasser, Avrum Gillespie, William J. Kostis, Marie Krousel-Wood, Joseph B. Muhlestein, Suzanne Oparil, Kwame Osei, Roberto Pisoni, Mark S. Segal, Alan Wiggers, Karen C. Johnson

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Background: To determine if the effects of intensive lowering of systolic blood pressure (goal of less than 120 mmHg) versus standard lowering (goal of less than 140 mmHg) upon cardiovascular, renal, and safety outcomes differed by gender. Methods: Nine thousand three hundred and sixty-one men and women aged 50 years or older with systolic blood pressure of 130mmHg or greater, taking 0-4 antihypertensive medications, and with increased risk of cardiovascular disease, but free of diabetes, were randomly assigned to either a systolic blood pressure target of less than 120mmHg (intensive treatment) or a target of less than 140mmHg (standard treatment). The primary composite outcome encompassed incident myocardial infarction, heart failure, other acute coronary syndromes, stroke, or cardiovascular-related death. All-cause mortality, renal outcomes, and serious adverse events were also assessed. Results: Compared with the standard treatment group, the primary composite outcome in the intensive treatment group was reduced by 16% [hazard ratio 0.84 (0.61- 1.13)] in women, and by 27% in men [hazard ratio 0.73 (0.59-0.89), P value for interaction between treatment and gender is 0.45]. Similarly, the effect of the intensive treatment on individual components of the primary composite outcome, renal outcomes, and overall serious adverse events was not significantly different according to gender. Conclusion: In adults with hypertension but not with diabetes, treatment to a systolic blood pressure goal of less than 120 mmHg, compared with a goal of less than 140 mmHg, resulted in no heterogeneity of effect between men and women on cardiovascular or renal outcomes, or on rates of serious adverse events.

Original languageEnglish (US)
Pages (from-to)904-915
Number of pages12
JournalJournal of Hypertension
Volume36
Issue number4
DOIs
StatePublished - Apr 2018

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Keywords

  • Blood pressure
  • Cardiovascular disease
  • Clinical trial outcomes
  • Gender
  • Hypertension

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