Association of baseline eGFR and incident heart failure on patients receiving intensive blood pressure treatment

Abstract Aims We aim to elucidate the association of baseline eGFR and incident heart failure on patients receiving intensive BP treatment. Methods and results A post hoc analysis was conducted on the SPRINT database. Multivariab le Cox regression and interaction restricted cubic spline (RCS) analys...

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Main Authors: Li Haonan, He Qiaorui, Zhu Wenqing, Zhang Yanjun, Pingcuo Wangjia, Yu Shikai, Deji Zhuoga, Zhang Yi, Zhao Yifan
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:ESC Heart Failure
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Online Access:https://doi.org/10.1002/ehf2.15232
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author Li Haonan
He Qiaorui
Zhu Wenqing
Zhang Yanjun
Pingcuo Wangjia
Yu Shikai
Deji Zhuoga
Zhang Yi
Zhao Yifan
author_facet Li Haonan
He Qiaorui
Zhu Wenqing
Zhang Yanjun
Pingcuo Wangjia
Yu Shikai
Deji Zhuoga
Zhang Yi
Zhao Yifan
author_sort Li Haonan
collection DOAJ
description Abstract Aims We aim to elucidate the association of baseline eGFR and incident heart failure on patients receiving intensive BP treatment. Methods and results A post hoc analysis was conducted on the SPRINT database. Multivariab le Cox regression and interaction restricted cubic spline (RCS) analysis were performed to investigate the interaction between baseline eGFR and intensive BP control on heart failure prevention. The primary endpoint focused on incident heart failure. The study cohort comprised 8369 adults with a mean [SD] age of 68 [59–77] years, including 2940 women (35.1%). Over a median [IQR] follow‐up period of 3.9 [2.0–5.0] years, 183 heart failure events were recorded. A significant interaction was observed between baseline eGFR and treatment groups in terms of heart failure prevention (Interaction P = 0.012). The risk of heart failure showed a sharp slope until eGFR = 75 mL/min/1.73 m2 and then became flat by an interaction RCS. Intensive BP treatment did not exhibit a preventive effect on heart failure (HR (95% CI) = 1.03 (0.82–1.52)) when baseline eGFR was 75 mL/min/1.73 m2 or lower. Conversely, when baseline eGFR was higher than 75 mL/min/1.73 m2, a reduced risk of heart failure was observed (HR (95% CI) = 0.65 (0.41–0.98)). Intensive BP control did not increase the incident long‐term dialysis regardless of baseline eGFR but was associated with a higher risk of eGFR reduction. Conclusions Among nondiabetic hypertensive patients, baseline eGFR serves as a crucial indicator for assessing the risk reduction potential of intensive BP control in heart failure prevention, with 75 mL/min/1.73 m2 appearing as a suitable cut‐off value.
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spelling doaj-art-38dfc933a37249488faba9d7fbb9c78c2025-08-20T02:14:43ZengWileyESC Heart Failure2055-58222025-06-011232148215610.1002/ehf2.15232Association of baseline eGFR and incident heart failure on patients receiving intensive blood pressure treatmentLi Haonan0He Qiaorui1Zhu Wenqing2Zhang Yanjun3Pingcuo Wangjia4Yu Shikai5Deji Zhuoga6Zhang Yi7Zhao Yifan8Heart Center, Shanghai Tenth People's Hospital, School of medicine Tongji University Shanghai ChinaHeart Center, Shanghai Tenth People's Hospital, School of medicine Tongji University Shanghai ChinaTongji University School of Medicine Tongji University Shanghai ChinaDepartment of Cardiology Shigatse People's Hospital Tibet ChinaDepartment of Cardiology Shigatse People's Hospital Tibet ChinaHeart Center, Shanghai Tenth People's Hospital, School of medicine Tongji University Shanghai ChinaDepartment of Cardiology Shigatse People's Hospital Tibet ChinaHeart Center, Shanghai Tenth People's Hospital, School of medicine Tongji University Shanghai ChinaHeart Center, Shanghai Tenth People's Hospital, School of medicine Tongji University Shanghai ChinaAbstract Aims We aim to elucidate the association of baseline eGFR and incident heart failure on patients receiving intensive BP treatment. Methods and results A post hoc analysis was conducted on the SPRINT database. Multivariab le Cox regression and interaction restricted cubic spline (RCS) analysis were performed to investigate the interaction between baseline eGFR and intensive BP control on heart failure prevention. The primary endpoint focused on incident heart failure. The study cohort comprised 8369 adults with a mean [SD] age of 68 [59–77] years, including 2940 women (35.1%). Over a median [IQR] follow‐up period of 3.9 [2.0–5.0] years, 183 heart failure events were recorded. A significant interaction was observed between baseline eGFR and treatment groups in terms of heart failure prevention (Interaction P = 0.012). The risk of heart failure showed a sharp slope until eGFR = 75 mL/min/1.73 m2 and then became flat by an interaction RCS. Intensive BP treatment did not exhibit a preventive effect on heart failure (HR (95% CI) = 1.03 (0.82–1.52)) when baseline eGFR was 75 mL/min/1.73 m2 or lower. Conversely, when baseline eGFR was higher than 75 mL/min/1.73 m2, a reduced risk of heart failure was observed (HR (95% CI) = 0.65 (0.41–0.98)). Intensive BP control did not increase the incident long‐term dialysis regardless of baseline eGFR but was associated with a higher risk of eGFR reduction. Conclusions Among nondiabetic hypertensive patients, baseline eGFR serves as a crucial indicator for assessing the risk reduction potential of intensive BP control in heart failure prevention, with 75 mL/min/1.73 m2 appearing as a suitable cut‐off value.https://doi.org/10.1002/ehf2.15232Cut‐off valueEstimated glomerular filtration rateIntensive blood pressure controlIncident heart failure
spellingShingle Li Haonan
He Qiaorui
Zhu Wenqing
Zhang Yanjun
Pingcuo Wangjia
Yu Shikai
Deji Zhuoga
Zhang Yi
Zhao Yifan
Association of baseline eGFR and incident heart failure on patients receiving intensive blood pressure treatment
ESC Heart Failure
Cut‐off value
Estimated glomerular filtration rate
Intensive blood pressure control
Incident heart failure
title Association of baseline eGFR and incident heart failure on patients receiving intensive blood pressure treatment
title_full Association of baseline eGFR and incident heart failure on patients receiving intensive blood pressure treatment
title_fullStr Association of baseline eGFR and incident heart failure on patients receiving intensive blood pressure treatment
title_full_unstemmed Association of baseline eGFR and incident heart failure on patients receiving intensive blood pressure treatment
title_short Association of baseline eGFR and incident heart failure on patients receiving intensive blood pressure treatment
title_sort association of baseline egfr and incident heart failure on patients receiving intensive blood pressure treatment
topic Cut‐off value
Estimated glomerular filtration rate
Intensive blood pressure control
Incident heart failure
url https://doi.org/10.1002/ehf2.15232
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