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Updated: Jun 18, 2025
Author Spotlight: Developing a Point-of-Care Hemoglobin Estimation Method for Anemia Management
Published on: January 19, 2024
Impact of Anemia on Cardiovascular Events and All-Cause Death Among Participants Who Received Intense Blood Pressure
Xiaochuan Liu1, Beiru Lin2, Sichen Yao3,4
1Department of General Practice, Zhongshan Hospital, Fudan University, 200032 Shanghai, China.
Insights
Anemia is linked to increased cardiovascular events and death in patients receiving intensive blood pressure treatment. This finding highlights anemia as a significant risk factor in this population.
Area of Science:
- Cardiology
- Hematology
- Clinical Trials
Background:
- The Systolic Blood Pressure Intervention Trial (SPRINT) investigated intensive blood pressure (BP) control.
- The association between anemia and cardiovascular outcomes in this specific patient group was not well-defined.
Purpose of the Study:
- To determine if anemia is associated with incident cardiovascular events and all-cause death in SPRINT participants undergoing intensive BP treatment.
Main Methods:
- 4394 participants from the SPRINT trial with intensive BP control (systolic BP < 120 mmHg) were analyzed.
- Anemia status was self-reported; primary outcome was composite cardiovascular events, secondary was all-cause death.
- Cox regression and inverse probability of treatment weighting (IPTW) were used to assess associations.
Main Results:
- Anemia was present in 537 participants and associated with older age and higher female proportion.
- Anemia significantly predicted composite cardiovascular events (HR 1.66, p=0.004; IPTW HR 1.55, p=0.024).
- Anemia also predicted higher all-cause death rates (IPTW HR 1.61, p=0.049).
Conclusions:
- Anemia is an independent risk factor for cardiovascular events and all-cause death in individuals receiving intensive BP control.
- These findings underscore the importance of considering anemia in cardiovascular risk assessment for patients with hypertension.
- Further research may explore mechanisms linking anemia to adverse outcomes in this population.
Background:
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).
Methods:
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.
Results:
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, p = 0.01) and more likely to be female (64.8% versus 31.8%, p 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, p = 0.004). The association remained statistically significant even in the population after IPTW (HR 1.55, 95% CI 1.06-2.27, p = 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, p = 0.049) in the population after IPTW.
Conclusions:
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.
Clinical Trial Registration:
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/).
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