UNASSIGNED: In the SPRINT (Systolic Blood Pressure Intervention Trial) MIND study, participants were categorized as having both hs-cTnT and NT-proBNP in the lower 2 tertiles (n=4226), one in the highest tertile (n=2379), and both in the highest tertile (n=1506). We assessed the effect of intensive versus standard treatment on the composite of mild cognitive impairment (MCI) or probable dementia (PD) across biomarker categories.
UNASSIGNED: Over a median follow-up of 5.1 years, 830 of 8111 participants (10.2%) developed MCI or PD. Participants in the highest biomarker category were at higher risk of MCI or PD compared with those in the lowest category (hazard ratio, 1.34 [95% CI, 1.00-1.56]). The effect of intensive treatment on reducing the risk of MCI or PD was greater among participants in the lowest biomarker category (hazard ratio, 0.64 [95% CI, 0.50-0.81]) than those in the intermediate (hazard ratio, 1.01 [95% CI, 0.80-1.28]) or highest categories (hazard ratio, 0.90 [95% CI, 0.72-1.13]; Pinteraction=0.02). The 5-year absolute risk differences in MCI or PD with intensive treatment were -2.9% (-4.4%, -1.3%), -0.2% (-3.0%, 2.6%), and -1.9% (-6.2%, 2.4%) in the lowest, intermediate, and highest biomarker categories, respectively.
UNASSIGNED: In SPRINT, the relative effect of intensive systolic blood pressure lowering on preventing cognitive impairment appears to be stronger among participants with lower compared with higher cardiac biomarker levels, though the absolute risk reductions were similar.
■在SPRINT(收缩压干预试验)心理研究中,参与者被归类为在较低的2个三位数中同时患有hs-cTnT和NT-proBNP(n=4226),最高三分位数之一(n=2379),并且都在最高三分位数(n=1506)。我们评估了强化治疗与标准治疗对生物标志物类别中轻度认知障碍(MCI)或可能的痴呆(PD)复合的影响。
■中位随访时间为5.1年,8111名参与者中有830名(10.2%)患有MCI或PD。与最低类别的参与者相比,最高生物标志物类别的参与者患MCI或PD的风险更高(风险比,1.34[95%CI,1.00-1.56])。在最低生物标志物类别的参与者中,强化治疗对降低MCI或PD风险的影响更大(风险比,0.64[95%CI,0.50-0.81])比中间体(危险比,1.01[95%CI,0.80-1.28])或最高类别(危险比,0.90[95%CI,0.72-1.13];P交互作用=0.02)。强化治疗的MCI或PD的5年绝对风险差异为-2.9%(-4.4%,-1.3%),-0.2%(-3.0%,2.6%),和-1.9%(-6.2%,2.4%)在最低,中间,和最高的生物标志物类别,分别。
■在SPRINT中,与较高的心脏生物标志物水平相比,在较低的参与者中,强化收缩压降低对预防认知障碍的相对作用似乎更强。尽管绝对风险降低是相似的。