Intensive blood pressure lowering reduces adverse cardiovascular outcomes among patients with high-normal glucose: An analysis from the Systolic Blood Pressure Intervention Trial database

The objective of this analysis is to determine the effect of intensive (<120mmHg) versus standard (<140mmHg) systolic blood pressure (SBP) targets on cardiovascular (CV) outcomes among SPRINT participants with low-normal or high-normal fasting glucose (FG). We categorized the 5425 SPRINT participants with FG <100mg/dL into 2 groups: <85mg/dL (low-normal) and 85 to <100mg/dL (high-normal). Among participants with low-normal glucose, there was no significant difference in the primary outcome (PO) between the 2 treatment arms (adjusted hazard ratio, HR: 1.27 (95% confidence interval [CI] 0.68-2.37, P=.46). However, the intensive SBP target was associated with 27% lower risk for the PO compared with the standard SBP target in those with high-normal glucose (HR 0.73, 0.57-0.93, P=.01). Our results indicate that hypertensive patients with high-normal FG may benefit from intensive SBP lowering, whereas benefits were inconclusive among those with low-normal FG.