{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T09:32:23Z","timestamp":1753522343836,"version":"3.40.5"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T00:00:00Z","timestamp":1617667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["7509"],"award-info":[{"award-number":["7509"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Uncontrolled blood pressure (BP) increases the risk of major adverse cardiovascular events. In SPRINT an intensive versus standard BP lowering strategy resulted in a lower rate of cardiovascular events and death. Whether BP reduction only or also the choice of anti\u2010hypertensive drugs is associated with outcomes remains to be elucidated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We aim to study the association of BP and different anti\u2010hypertensive drugs with several cardiovascular outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Time\u2010updated Cox and mixed\u2010effects models. The primary outcome was a composite of first myocardial infarction, acute coronary syndrome, stroke, heart failure, or cardiovascular death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 9361 patients were included. The anti\u2010hypertensive agents most frequently used were ACEi\/ARBs, with an almost 20% higher prescription rate in the intensive arm (80% vs. 61%), followed by thiazide\u2010type diuretics (65% vs. 42%), calcium\u2010channel blockers (57% vs. 39%), and beta\u2010blockers (52% vs. 26%). Mineralocorticoid receptor antagonists were rarely used (\u22647% of the observations). In multivariate analysis, the use of ACEi\/ARBs, especially in combination with thiazides, were independently associated with a lower primary outcome event\u2010rate (HR [95%CI] 0.75 [0.61\u20130.92], <jats:italic>p<\/jats:italic>\u00a0=\u00a0.006), whereas a DBP &lt;60\u2009mmHg was independently associated with a higher event\u2010rate (HR [95%CI] 1.36 [1.07\u20131.71], <jats:italic>p<\/jats:italic>\u00a0=\u00a0.011). SBP &lt;120\u2009mmHg was associated with lower rate of cardiovascular and all\u2010cause death on intensive treatment but not on the standard arm (interaction <jats:italic>p<\/jats:italic> &lt; .05 for both).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In SPRINT, an intensive therapy strategy achieving SBP &lt;120\u2009mmHg with a DBP \u226560\u2009mmHg, and using ACEi\/ARBs plus thiazides was associated with a lower event\u2010rate.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23591","type":"journal-article","created":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T10:42:48Z","timestamp":1617705768000},"page":"665-674","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Blood pressure reduction and anti\u2010hypertensive treatment choice: A post\u2010hoc analysis of the <scp>SPRINT<\/scp> trial"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2304-6138","authenticated-orcid":false,"given":"Jo\u00e3o Pedro","family":"Ferreira","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Lorraine, Centre d'Investigations Cliniques Plurith\u00e9matique Inserm 1433, CHRU de Nancy Inserm U1116, FCRIN INI\u2010CRCT  Nancy France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Gregson","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"B\u00f6hm","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin III Saarland University Medical Center  Homburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Rossignol","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, Centre d'Investigations Cliniques Plurith\u00e9matique Inserm 1433, CHRU de Nancy Inserm U1116, FCRIN INI\u2010CRCT  Nancy France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faiez","family":"Zannad","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, Centre d'Investigations Cliniques Plurith\u00e9matique Inserm 1433, CHRU de Nancy Inserm U1116, FCRIN INI\u2010CRCT  Nancy France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2212-4007","authenticated-orcid":false,"given":"Stuart J.","family":"Pocock","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics London School of Hygiene and Tropical Medicine  London 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