Liu Xiaochuan, Lin Beiru, Yao Sichen, Pan Zhigang
Department of General Practice, Zhongshan Hospital, Fudan University, 200032 Shanghai, China.
Department of General Practice, Hainan West Central Hospital, 571700 Danzhou, Hainan, China.
Rev Cardiovasc Med. 2024 Jan 8;25(1):6. doi: 10.31083/j.rcm2501006. eCollection 2024 Jan.
To investigate whether anemia is associated with incident cardiovascular events and all-cause death among participants who received intensive blood pressure (BP) treatment in the Systolic Blood Pressure Intervention Trial (SPRINT).
A total of 4394 participants who received intensive BP control (systolic BP 120 mmHg) in SPRINT were included. Anemia status was self-reported. Our primary outcome was a composite of cardiovascular events, and the secondary outcome was all-cause death. Cox regression was used to compare the incidence of outcomes between participants with anemia and non-anemia. In order to balance the baseline characteristics between the 2 groups, inverse probability of treatment weighting (IPTW) was applied. Hazard ratios (HRs), along with 95% confidence intervals (CIs), were then calculated.
There were 4394 participants who received intensive BP control (537 participants with anemia). Participants with anemia were older (mean age 68.86 versus 67.75, = 0.01) and more likely to be female (64.8% versus 31.8%, 0.001). The presence of anemia was strongly associated with composite cardiovascular events after adjusting for potential confounders (HR 1.66, 95% CI 1.18-2.34, = 0.004). The association remained statistically significant even in the population after IPTW (HR 1.55, 95% CI 1.06-2.27, = 0.024). The secondary outcome revealed that participants with anemia had a higher rate of all-cause death compared to those without anemia. The HR of all-cause death for participants with anemia was 1.61 (95% CI 1.00-2.57, = 0.049) in the population after IPTW.
Anemia appears to be an independent risk factor for composite cardiovascular events and all-cause death among participants who received intensive BP control in SPRINT.
URL: https://www.clinicaltrials.gov; Unique identifier: NCT01206062. All SPRINT anonymized data can be found at the National Heart, Lung and Blood Institute (NHLBI) Biologic Specimen and Data Repository (https://biolincc.nhlbi.nih.gov/home/).
在收缩压干预试验（SPRINT）中，研究接受强化血压（BP）治疗的参与者中贫血是否与心血管事件及全因死亡相关。
纳入SPRINT中4394例接受强化血压控制（收缩压≤120 mmHg）的参与者。贫血状况通过自我报告获得。我们的主要结局是心血管事件的复合终点，次要结局是全因死亡。采用Cox回归比较贫血和非贫血参与者的结局发生率。为平衡两组的基线特征，应用了治疗权重逆概率（IPTW）。然后计算风险比（HR）及95%置信区间（CI）。
4394例接受强化血压控制的参与者（537例贫血参与者）。贫血参与者年龄更大（平均年龄68.86岁对67.75岁，P = 0.01）且更可能为女性（64.8%对31.8%，P<0.001）。校正潜在混杂因素后，贫血与心血管事件复合终点显著相关（HR 1.66，95%CI 1.18 - 2.34，P = 0.004）。即使在IPTW后的人群中，该关联仍具有统计学意义（HR 1.55，95%CI 1.06 - 2.27，P = 0.024）。次要结局显示，贫血参与者的全因死亡率高于非贫血参与者。IPTW后人群中贫血参与者全因死亡的HR为1.61（95%CI 1.00 - 2.57，P = 0.049）。
在SPRINT中接受强化血压控制的参与者中，贫血似乎是心血管事件复合终点和全因死亡的独立危险因素。
