Supplemental Digital Content is available in the text. The SPRINT (Systolic Blood Pressure Intervention Trial) demonstrated reduced cardiovascular outcomes. We evaluated diabetes mellitus incidence in this randomized trial that compared intensive blood pressure strategy (systolic blood pressure <120 mm Hg) versus standard strategy (<140 mm Hg). Participants were ≥50 years of age, with systolic 130 to 180 mm Hg and increased cardiovascular risk. Participants were excluded if they had diabetes mellitus, polycystic kidney disease, proteinuria >1 g/d, heart failure, dementia, or stroke. Postrandomization exclusions included participants missing blood glucose or ≥126 mg/dL (6.99 mmol/L) or on hypoglycemics. The outcome was incident diabetes mellitus: fasting blood glucose ≥126 mg/dL (6.99 mmol/L), diabetes mellitus self-report, or new use of hypoglycemics. The secondary outcome was impaired fasting glucose (100–125 mg/dL [5.55–6.94 mmol/L]) among those with normoglycemia (<100 mg/dL [5.55 mmol/L]). There were 9361 participants randomized and 981 excluded, yielding 4187 and 4193 participants assigned to intensive and standard strategies. There were 299 incident diabetes mellitus events (2.3% per year) for intensive and 251 events (1.9% per year) for standard, rates of 22.6 (20.2–25.3) versus 19.0 (16.8–21.5) events per 1000 person-years of treatment, respectively (adjusted hazard ratio, 1.19 [95% CI, 0.95–1.49]). Impaired fasting glucose rates were 26.4 (24.9–28.0) and 22.5 (21.1–24.1) per 100 person-years for intensive and standard strategies (adjusted hazard ratio, 1.17 [1.06–1.30]). Intensive treatment strategy was not associated with increased diabetes mellitus but was associated with more impaired fasting glucose. The risks and benefits of intensive blood pressure targets should be factored into individualized patient treatment goals. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01206062.

中文翻译：

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血压控制与糖尿病发病率的关系

文本中提供了补充数字内容。SPRINT（收缩压干预试验）显示心血管结局降低。我们在这项比较强化血压策略（收缩压<120 mm Hg）与标准策略（<140 mm Hg）的随机试验中评估了糖尿病发病率。参与者年龄≥50 岁，收缩压 130 至 180 mm Hg，心血管风险增加。如果参与者患有糖尿病、多囊肾病、蛋白尿 > 1 g/d、心力衰竭、痴呆或中风，则被排除在外。随机化后排除包括血糖缺失或≥126 mg/dL (6.99 mmol/L) 或服用降糖药的参与者。结果是糖尿病事件：空腹血糖≥126 mg/dL (6.99 mmol/L)，糖尿病自我报告，或新使用降糖药。次要结局是血糖正常（<100 mg/dL [5.55 mmol/L]）的空腹血糖受损（100-125 mg/dL [5.55-6.94 mmol/L]）。有 9361 名参与者被随机化，981 人被排除在外，分别有 4187 和 4193 名参与者被分配到强化策略和标准策略。每 1000 人年治疗有 299 起糖尿病事件（每年 2.3%）和 251 起事件（每年 1.9%），每 1000 人年治疗发生率分别为 22.6（20.2-25.3）和 19.0（16.8-21.5）事件，分别（调整后的风险比，1.19 [95% CI，0.95–1.49]）。强化和标准策略的空腹血糖受损率分别为每 100 人年 26.4 (24.9–28.0) 和 22.5 (21.1–24.1)（调整后的风险比，1.17 [1.06–1.30]）。强化治疗策略与糖尿病增加无关，但与更多的空腹血糖受损相关。强化血压目标的风险和益处应纳入个体化患者治疗目标。临床试验注册——网址：http://www.clinicaltrials.gov。唯一标识符：NCT01206062。