Intensive Blood Pressure Strategy on Cardiovascular Diseases in Patients With Metabolic Syndrome: Post Hoc Analysis of a Clinical Trial
Background Blood pressure (BP) management in patients with metabolic syndrome is complex, and optimal targets remain debated. The CRHCP (China Rural Hypertension Control Project) trial demonstrated that intensive BP control reduces cardiovascular events. This secondary analysis assessed its efficacy...
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Wiley
2025-03-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.036820 |
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| author | Guozhe Sun Xiaofan Guo Guangxiao Li Pengyu Zhang Yangzhi Yin Lixia Qiao Ning Ye Chang Wang Songyue Liu Danxi Geng Wei Miao Ziyi Xie Yao Yu Zhi Li Xiaoqiong Jiang Xiangyu Tan Yingxian Sun |
| author_facet | Guozhe Sun Xiaofan Guo Guangxiao Li Pengyu Zhang Yangzhi Yin Lixia Qiao Ning Ye Chang Wang Songyue Liu Danxi Geng Wei Miao Ziyi Xie Yao Yu Zhi Li Xiaoqiong Jiang Xiangyu Tan Yingxian Sun |
| author_sort | Guozhe Sun |
| collection | DOAJ |
| description | Background Blood pressure (BP) management in patients with metabolic syndrome is complex, and optimal targets remain debated. The CRHCP (China Rural Hypertension Control Project) trial demonstrated that intensive BP control reduces cardiovascular events. This secondary analysis assessed its efficacy in patients with hypertension and metabolic syndrome. Methods and Results This a post hoc analysis of a cluster randomized trial (NCT03527719) across 3 Chinese provinces; 18 076 hypertensive patients with metabolic syndrome were followed up for 3 years. Intervention groups received multifaceted BP management by nonphysician health care professionals aiming for <130/80 mm Hg BP under physician supervision. The primary outcome of major adverse cardiovascular events included stroke, myocardial infarction, heart failure, and death from cardiovascular causes, during a 3‐year follow‐up. A total of 18 076 participants (median [range] age, 63 [54–72] years; 13 056 [72.2%] women) were enrolled in 2 clusters and were adjudicated for the primary outcome (control, 9337; intervention, 8739). At the end of the 3‐year follow‐up, the mean systolic/diastolic BP was 126.3/73.0 mm Hg in the intervention group versus 147.3/82.0 mm Hg in the usual care group. Compared with the usual care group, the intervention group had a lower rate of major adverse cardiovascular events (1.58% versus 2.42% per year; hazard ratio [HR], 0.65 [95% CI, 0.57–0.74]; P<0.001), as well as stroke (HR, 0.68 [95% CI, 0.55–0.83]; P=0.015), myocardial infarction (HR, 0.70 [95% CI, 0.51–0.97]; P=0.034), death from cardiovascular causes (HR, 0.67 [95% CI, 0.47–0.96]; P=0.029), and death from all causes (HR, 0.82 [95% CI, 0.71–0.94]; P=0.005). Conclusions Intensive BP control (<130/80 mm Hg) by trained nonphysician community health care professionals effectively reduces cardiovascular events in patients with hypertension and metabolic syndrome. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03527719. |
| format | Article |
| id | doaj-art-5e7e4b05570c421e9d369db2b45e5658 |
| institution | DOAJ |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-5e7e4b05570c421e9d369db2b45e56582025-08-20T03:07:41ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-03-0114610.1161/JAHA.124.036820Intensive Blood Pressure Strategy on Cardiovascular Diseases in Patients With Metabolic Syndrome: Post Hoc Analysis of a Clinical TrialGuozhe Sun0Xiaofan Guo1Guangxiao Li2Pengyu Zhang3Yangzhi Yin4Lixia Qiao5Ning Ye6Chang Wang7Songyue Liu8Danxi Geng9Wei Miao10Ziyi Xie11Yao Yu12Zhi Li13Xiaoqiong Jiang14Xiangyu Tan15Yingxian Sun16Department of Cardiology The First Hospital of China Medical University Shenyang ChinaDepartment of Cardiology The First Hospital of China Medical University Shenyang ChinaDepartment of Medical Record Management Center First Hospital of China Medical University Shenyang ChinaDepartment of Cardiology The First Hospital of China Medical University Shenyang ChinaDepartment of Cardiology The First Hospital of China Medical University Shenyang ChinaDepartment of Cardiology The First Hospital of China Medical University Shenyang ChinaDepartment of Cardiology The First Hospital of China Medical University Shenyang ChinaDepartment of Cardiology The First Hospital of China Medical University Shenyang ChinaDepartment of Cardiology The First Hospital of China Medical University Shenyang ChinaDepartment of Cardiology The First Hospital of China Medical University Shenyang ChinaDepartment of Cardiology The First Hospital of China Medical University Shenyang ChinaDepartment of Cardiology The First Hospital of China Medical University Shenyang ChinaDepartment of Cardiology The First Hospital of China Medical University Shenyang ChinaDepartment of Cardiology The First Hospital of China Medical University Shenyang ChinaDepartment of Cardiology The First Hospital of China Medical University Shenyang ChinaDepartment of Cardiology The First Hospital of China Medical University Shenyang ChinaDepartment of Cardiology The First Hospital of China Medical University Shenyang ChinaBackground Blood pressure (BP) management in patients with metabolic syndrome is complex, and optimal targets remain debated. The CRHCP (China Rural Hypertension Control Project) trial demonstrated that intensive BP control reduces cardiovascular events. This secondary analysis assessed its efficacy in patients with hypertension and metabolic syndrome. Methods and Results This a post hoc analysis of a cluster randomized trial (NCT03527719) across 3 Chinese provinces; 18 076 hypertensive patients with metabolic syndrome were followed up for 3 years. Intervention groups received multifaceted BP management by nonphysician health care professionals aiming for <130/80 mm Hg BP under physician supervision. The primary outcome of major adverse cardiovascular events included stroke, myocardial infarction, heart failure, and death from cardiovascular causes, during a 3‐year follow‐up. A total of 18 076 participants (median [range] age, 63 [54–72] years; 13 056 [72.2%] women) were enrolled in 2 clusters and were adjudicated for the primary outcome (control, 9337; intervention, 8739). At the end of the 3‐year follow‐up, the mean systolic/diastolic BP was 126.3/73.0 mm Hg in the intervention group versus 147.3/82.0 mm Hg in the usual care group. Compared with the usual care group, the intervention group had a lower rate of major adverse cardiovascular events (1.58% versus 2.42% per year; hazard ratio [HR], 0.65 [95% CI, 0.57–0.74]; P<0.001), as well as stroke (HR, 0.68 [95% CI, 0.55–0.83]; P=0.015), myocardial infarction (HR, 0.70 [95% CI, 0.51–0.97]; P=0.034), death from cardiovascular causes (HR, 0.67 [95% CI, 0.47–0.96]; P=0.029), and death from all causes (HR, 0.82 [95% CI, 0.71–0.94]; P=0.005). Conclusions Intensive BP control (<130/80 mm Hg) by trained nonphysician community health care professionals effectively reduces cardiovascular events in patients with hypertension and metabolic syndrome. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03527719.https://www.ahajournals.org/doi/10.1161/JAHA.124.036820cardiovascular diseasesintensive blood pressure strategymetabolic syndrome |
| spellingShingle | Guozhe Sun Xiaofan Guo Guangxiao Li Pengyu Zhang Yangzhi Yin Lixia Qiao Ning Ye Chang Wang Songyue Liu Danxi Geng Wei Miao Ziyi Xie Yao Yu Zhi Li Xiaoqiong Jiang Xiangyu Tan Yingxian Sun Intensive Blood Pressure Strategy on Cardiovascular Diseases in Patients With Metabolic Syndrome: Post Hoc Analysis of a Clinical Trial Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiovascular diseases intensive blood pressure strategy metabolic syndrome |
| title | Intensive Blood Pressure Strategy on Cardiovascular Diseases in Patients With Metabolic Syndrome: Post Hoc Analysis of a Clinical Trial |
| title_full | Intensive Blood Pressure Strategy on Cardiovascular Diseases in Patients With Metabolic Syndrome: Post Hoc Analysis of a Clinical Trial |
| title_fullStr | Intensive Blood Pressure Strategy on Cardiovascular Diseases in Patients With Metabolic Syndrome: Post Hoc Analysis of a Clinical Trial |
| title_full_unstemmed | Intensive Blood Pressure Strategy on Cardiovascular Diseases in Patients With Metabolic Syndrome: Post Hoc Analysis of a Clinical Trial |
| title_short | Intensive Blood Pressure Strategy on Cardiovascular Diseases in Patients With Metabolic Syndrome: Post Hoc Analysis of a Clinical Trial |
| title_sort | intensive blood pressure strategy on cardiovascular diseases in patients with metabolic syndrome post hoc analysis of a clinical trial |
| topic | cardiovascular diseases intensive blood pressure strategy metabolic syndrome |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.036820 |
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