OBJECTIVE To determine whether the effects of intensive (<120 mmHg) compared with standard (<140 mmHg) systolic blood pressure (SBP) treatment are different among those with prediabetes versus those with fasting normoglycemia at baseline in the Systolic Blood Pressure Intervention Trial (SPRINT). RESEARCH DESIGN AND METHODS This was a post hoc analysis of SPRINT. SPRINT participants were categorized by prediabetes status, defined as baseline fasting serum glucose ≥100 mg/dL versus those with normoglycemia (fasting serum glucose <100 mg/dL). The primary outcome was a composite of myocardial infarction, acute coronary syndrome not resulting in myocardial infarction, stroke, acute decompensated heart failure, or death from cardiovascular causes. Cox regression was used to calculate hazard ratios for study outcomes with intensive compared with standard SBP treatment among those with prediabetes and normoglycemia. RESULTS Among 9,361 participants randomized (age 67.9 ± 9.4 years; 35.5% female), 3,898 and 5,425 had baseline prediabetes and normoglycemia, respectively. After a median follow-up of 3.26 years, the hazard ratio for the primary outcome was 0.69 (95% CI 0.53, 0.89) and 0.83 (95% CI 0.66, 1.03) among those with prediabetes and normoglycemia, respectively (P value for interaction 0.30). For all-cause mortality, the hazard ratio with intensive SBP treatment was 0.77 (95% CI 0.55, 1.06) for prediabetes and 0.71 (95% CI 0.54, 0.94) for normoglycemia (P value for interaction 0.74). Effects of intensive versus standard SBP treatment on prespecified renal outcomes and serious adverse events were similar for prediabetes and normoglycemia (all interaction P > 0.05). CONCLUSIONS In SPRINT, the beneficial effects of intensive SBP treatment were similar among those with prediabetes and fasting normoglycemia.

中文翻译：

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根据基线糖尿病前期状况进行强化对标准血压治疗的效果：一项随机试验的事后分析。

目的在收缩压干预试验（SPRINT）中，确定前期糖尿病患者与基线时空腹血糖正常的患者相比，强化（<120 mmHg）与标准（<140 mmHg）收缩压（SBP）治疗的效果是否不同）。研究设计和方法这是对SPRINT的事后分析。SPRINT参与者按糖尿病前状态分类，定义为基线空腹血糖≥100mg / dL与正常血糖水平（空腹血糖<100 mg / dL）的基线空腹血糖。主要结局是心肌梗死，急性冠状动脉综合征未导致心肌梗塞，中风，急性代偿性心力衰竭或心血管原因死亡的复合结果。使用Cox回归来计算糖尿病前期和血糖正常者中与标准SBP治疗相比强化治疗的研究结果的危险比。结果在随机分配的9,361名参与者（年龄67.9±9.4岁；女性35.5％）中，有3,898名和5,425名患有基线糖尿病前期和正常血糖水平。在中位随访时间为3.26年之后，糖尿病前期和血糖正常者的主要结局风险比分别为0.69（95％CI 0.53，0.89）和0.83（95％CI 0.66，1.03）（交互作用的P值） 0.30）。对于全因死亡率，糖尿病前期患者接受强化SBP治疗的危险比为0.77（95％CI 0.55，1.06），而正常血糖为0.71（95％CI 0.54，0.94）（相互作用的P值为0.74）。对于糖尿病前期和血糖正常的患者，强化SBP治疗与标准SBP治疗对预先指定的肾脏结局和严重不良事件的影响相似（所有相互作用P> 0.05）。结论在SPRINT中，强化SBP治疗的有益效果在糖尿病前期和空腹血糖正常的患者中相似。