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Effect of Intensive Blood Pressure Control on Cardiovascular Outcomes in Cancer Survivors.
Li, Wenjie; Wang, Zhiyan; Jiang, Chao; Hua, Chang; Tang, Yangyang; Zhang, Hao; Liu, Xinru; Zheng, Shiyue; Wang, Yufeng; Gao, Mingyang; Lv, Qiang; Dong, Jianzeng; Ma, Changsheng; Du, Xin.
Afiliación
  • Li W; Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China (W.L., Z.W., C.J., C.H., Y.T., H.Z., X.L., S.Z., Y.W., M.G., Q.L., J.D., C.M., X.D.).
  • Wang Z; Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China (W.L., Z.W., C.J., C.H., Y.T., H.Z., X.L., S.Z., Y.W., M.G., Q.L., J.D., C.M., X.D.).
  • Jiang C; Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China (W.L., Z.W., C.J., C.H., Y.T., H.Z., X.L., S.Z., Y.W., M.G., Q.L., J.D., C.M., X.D.).
  • Hua C; Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China (W.L., Z.W., C.J., C.H., Y.T., H.Z., X.L., S.Z., Y.W., M.G., Q.L., J.D., C.M., X.D.).
  • Tang Y; Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China (W.L., Z.W., C.J., C.H., Y.T., H.Z., X.L., S.Z., Y.W., M.G., Q.L., J.D., C.M., X.D.).
  • Zhang H; Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China (W.L., Z.W., C.J., C.H., Y.T., H.Z., X.L., S.Z., Y.W., M.G., Q.L., J.D., C.M., X.D.).
  • Liu X; Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China (W.L., Z.W., C.J., C.H., Y.T., H.Z., X.L., S.Z., Y.W., M.G., Q.L., J.D., C.M., X.D.).
  • Zheng S; Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China (W.L., Z.W., C.J., C.H., Y.T., H.Z., X.L., S.Z., Y.W., M.G., Q.L., J.D., C.M., X.D.).
  • Wang Y; Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China (W.L., Z.W., C.J., C.H., Y.T., H.Z., X.L., S.Z., Y.W., M.G., Q.L., J.D., C.M., X.D.).
  • Gao M; Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China (W.L., Z.W., C.J., C.H., Y.T., H.Z., X.L., S.Z., Y.W., M.G., Q.L., J.D., C.M., X.D.).
  • Lv Q; Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China (W.L., Z.W., C.J., C.H., Y.T., H.Z., X.L., S.Z., Y.W., M.G., Q.L., J.D., C.M., X.D.).
  • Dong J; Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China (W.L., Z.W., C.J., C.H., Y.T., H.Z., X.L., S.Z., Y.W., M.G., Q.L., J.D., C.M., X.D.).
  • Ma C; Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Henan Province, China (J.D.).
  • Du X; Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China (W.L., Z.W., C.J., C.H., Y.T., H.Z., X.L., S.Z., Y.W., M.G., Q.L., J.D., C.M., X.D.).
Hypertension ; 81(3): 620-628, 2024 Mar.
Article en En | MEDLINE | ID: mdl-38164752
ABSTRACT

BACKGROUND:

To evaluate whether cancer modifies the effect of intensive blood pressure control on major cardiovascular outcomes.

METHODS:

Using data of the SPRINT (Systolic Blood Pressure Intervention Trial), we compared the risk of the composite outcomes of myocardial infarction, other acute coronary syndromes, stroke, heart failure, and cardiovascular death in patients with and without a history of cancer. Using Cox proportional hazards regression, we tested interactions between history of cancer and intensive blood pressure control on major cardiovascular outcomes.

RESULTS:

The study included a total of 9336 patients, with a mean age of 67.9±9.4 years, among whom 2066 (22.2%) were cancer survivors. Over a median follow-up of 3.2 years, 561 primary cardiovascular outcomes were observed. Cancer survivors had a similar risk of experiencing the primary outcome compared with patients without cancer after multivariable adjustment (adjusted hazard ratio, 0.94 [95% CI, 0.77-1.15]). Intensive blood pressure control reduced risk of the primary cardiovascular outcome similarly for cancer survivors (hazard ratio, 0.70 [95% CI, 0.51-0.97]) and patients without cancer (HR, 0.76 [95% CI, 0.63-0.93]; P for interaction 0.74).

CONCLUSIONS:

In SPRINT study, intensive blood pressure treatment reduced the risk of major cardiovascular events in cancer survivors to a similar extent to that of patients without cancer. Cancer history not requiring active treatment in last 2 years should not be an obstacle to intensive treatment of hypertension. This post hoc analysis should be considered as hypothesis-generating and merit further clinical trial. REGISTRATION URL https//www.clinicaltrials.gov; Unique identifier NCT01206062.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 1_ASSA2030 / 2_ODS3 / 6_ODS3_enfermedades_notrasmisibles Problema de salud: 1_doencas_nao_transmissiveis / 2_muertes_prematuras_enfermedades_notrasmisibles / 6_arterial_hypertension / 6_cardiovascular_diseases / 6_ischemic_heart_disease Asunto principal: Supervivientes de Cáncer / Hipertensión / Infarto del Miocardio / Neoplasias Tipo de estudio: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans / Middle aged Idioma: En Revista: Hypertension Año: 2024 Tipo del documento: Article
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 1_ASSA2030 / 2_ODS3 / 6_ODS3_enfermedades_notrasmisibles Problema de salud: 1_doencas_nao_transmissiveis / 2_muertes_prematuras_enfermedades_notrasmisibles / 6_arterial_hypertension / 6_cardiovascular_diseases / 6_ischemic_heart_disease Asunto principal: Supervivientes de Cáncer / Hipertensión / Infarto del Miocardio / Neoplasias Tipo de estudio: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans / Middle aged Idioma: En Revista: Hypertension Año: 2024 Tipo del documento: Article