{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T18:18:25Z","timestamp":1788459505890,"version":"build-2803163510"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Acute decompensated heart failure (ADHF) was a frequent common outcome in SPRINT (Systolic Blood Pressure Intervention Trial). We examined whether there was differential reduction in ADHF events from intensive blood pressure [BP] treatment among the 6 key, prespecified subgroups in SPRINT: age \u226575 years, prior cardiovascular disease, chronic kidney disease, women, black race, and 3 levels of baseline systolic BP (\u2264132 versus &gt;132 to &lt;145 versus \u2265145 mm\u2009Hg).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      ADHF was defined as hospitalization for ADHF, confirmed and formally adjudicated by a blinded events committee using standardized protocols. At 3.29 years follow-up, there were 103 ADHF events (2.2%) among 4683 standard arm participants and 65 ADHF events (1.4%) among 4678 intensive arm participants (Cox proportional hazards ratio, 0.63; 95% confidence interval, 0.46\u20130.85;\n                      <jats:italic>P<\/jats:italic>\n                      value =0.003). In multivariable analyses, including treatment arm, baseline covariates that were significant predictors for ADHF included chronic kidney disease, cardiovascular disease, age\u226575 years, body mass index, and higher systolic BP. The beneficial effect of the intervention on incident ADHF was consistent across all prespecified subgroups. Participants who had incident ADHF had markedly increased risk of subsequent cardiovascular events, including a 27-fold increase (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) in cardiovascular death.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>Targeting a systolic BP&lt;120 mm\u2009Hg, compared with &lt;140 mm\u2009Hg, significantly reduced ADHF events, and the benefit was similar across all key, prespecified subgroups. Participants who developed ADHF had markedly increased risk for subsequent cardiovascular events and death, highlighting the importance of strategies aimed at prevention of ADHF, especially intensive BP reduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      . Unique identifier: NCT01206062\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.116.003613","type":"journal-article","created":{"date-parts":[[2017,3,31]],"date-time":"2017-03-31T21:05:22Z","timestamp":1490994322000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":104,"title":["Effect of Intensive Blood Pressure Treatment on Heart Failure Events in the Systolic Blood Pressure Reduction Intervention Trial"],"prefix":"10.1161","volume":"10","author":[{"given":"Bharathi","family":"Upadhya","sequence":"first","affiliation":[{"name":"From the Cardiovascular Medicine Section (B.U., C.J.R., D.W.K.), Nephrology Section, Department of Internal Medicine (M.R.), and Biostatistics (L.C.L.), Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine (C.E.L.) and Division of Cardiovascular Disease (S.O.), Department of Medicine, University of Alabama, Birmingham; Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Michael E. DeBakey Veterans Affairs Medical Center and Baylor College..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Rocco","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine Section (B.U., C.J.R., D.W.K.), Nephrology Section, Department of Internal Medicine (M.R.), and Biostatistics (L.C.L.), Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine (C.E.L.) and Division of Cardiovascular Disease (S.O.), Department of Medicine, University of Alabama, Birmingham; Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Michael E. DeBakey Veterans Affairs Medical Center and Baylor College..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cora E.","family":"Lewis","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine Section (B.U., C.J.R., D.W.K.), Nephrology Section, Department of Internal Medicine (M.R.), and Biostatistics (L.C.L.), Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine (C.E.L.) and Division of Cardiovascular Disease (S.O.), Department of Medicine, University of Alabama, Birmingham; Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Michael E. DeBakey Veterans Affairs Medical Center and Baylor College..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Oparil","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine Section (B.U., C.J.R., D.W.K.), Nephrology Section, Department of Internal Medicine (M.R.), and Biostatistics (L.C.L.), Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine (C.E.L.) and Division of Cardiovascular Disease (S.O.), Department of Medicine, University of Alabama, Birmingham; Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Michael E. DeBakey Veterans Affairs Medical Center and Baylor College..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura C.","family":"Lovato","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine Section (B.U., C.J.R., D.W.K.), Nephrology Section, Department of Internal Medicine (M.R.), and Biostatistics (L.C.L.), Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine (C.E.L.) and Division of Cardiovascular Disease (S.O.), Department of Medicine, University of Alabama, Birmingham; Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Michael E. DeBakey Veterans Affairs Medical Center and Baylor College..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Cushman","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine Section (B.U., C.J.R., D.W.K.), Nephrology Section, Department of Internal Medicine (M.R.), and Biostatistics (L.C.L.), Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine (C.E.L.) and Division of Cardiovascular Disease (S.O.), Department of Medicine, University of Alabama, Birmingham; Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Michael E. DeBakey Veterans Affairs Medical Center and Baylor College..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey T.","family":"Bates","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine Section (B.U., C.J.R., D.W.K.), Nephrology Section, Department of Internal Medicine (M.R.), and Biostatistics (L.C.L.), Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine (C.E.L.) and Division of Cardiovascular Disease (S.O.), Department of Medicine, University of Alabama, Birmingham; Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Michael E. DeBakey Veterans Affairs Medical Center and Baylor College..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie A.","family":"Bello","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine Section (B.U., C.J.R., D.W.K.), Nephrology Section, Department of Internal Medicine (M.R.), and Biostatistics (L.C.L.), Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine (C.E.L.) and Division of Cardiovascular Disease (S.O.), Department of Medicine, University of Alabama, Birmingham; Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Michael E. DeBakey Veterans Affairs Medical Center and Baylor College..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard","family":"Aurigemma","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine Section (B.U., C.J.R., D.W.K.), Nephrology Section, Department of Internal Medicine (M.R.), and Biostatistics (L.C.L.), Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine (C.E.L.) and Division of Cardiovascular Disease (S.O.), Department of Medicine, University of Alabama, Birmingham; Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Michael E. DeBakey Veterans Affairs Medical Center and Baylor College..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence J.","family":"Fine","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine Section (B.U., C.J.R., D.W.K.), Nephrology Section, Department of Internal Medicine (M.R.), and Biostatistics (L.C.L.), Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine (C.E.L.) and Division of Cardiovascular Disease (S.O.), Department of Medicine, University of Alabama, Birmingham; Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Michael E. DeBakey Veterans Affairs Medical Center and Baylor College..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen C.","family":"Johnson","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine Section (B.U., C.J.R., D.W.K.), Nephrology Section, Department of Internal Medicine (M.R.), and Biostatistics (L.C.L.), Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine (C.E.L.) and Division of Cardiovascular Disease (S.O.), Department of Medicine, University of Alabama, Birmingham; Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Michael E. 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DeBakey Veterans Affairs Medical Center and Baylor College..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic S.","family":"Raj","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Medicine Section (B.U., C.J.R., D.W.K.), Nephrology Section, Department of Internal Medicine (M.R.), and Biostatistics (L.C.L.), Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine (C.E.L.) and Division of Cardiovascular Disease (S.O.), Department of Medicine, University of Alabama, Birmingham; Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Michael E. 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