Abstract 10095: Beneficial Effects of Intensive Blood Pressure Control on Cardiovascular Outcomes Are Seen in Cohabitating Black Individuals but Not in Those Living Alone

Abstract

Introduction: Living alone, a key proxy of social isolation, is a risk factor for cardiovascular disease. In addition, Black race is associated with less optimal blood pressure (BP) control than in other racial/ethnic groups. However, it is not clear whether living arrangement modifies the beneficial effects of intensive BP control on reduction in cardiovascular events among Black individuals. We aimed to examine whether the effects of intensive BP control on cardiovascular events differ by living arrangement among Black and non-Black individuals in the Systolic Blood Pressure Intervention Trial (SPRINT). Methods: This secondary analysis of the SPRINT trial included 9,361 participants (30% Black individuals; 29% living alone) who were randomized to a systolic BP target of either <120mmHg (intensive treatment group) or <140mmHg (standard treatment group). Cox proportional hazards model was used to estimate the effect of intensive treatment on the composite cardiovascular outcome according to living arrangement (i.e., living alone or living with others) among Black and non-Black individuals. Results: At a median follow-up of 3.2 years, the intensive treatment group showed a significantly lower rate of the composite cardiovascular outcome than the standard treatment group among cohabitating Black individuals (hazard ratio [HR], 0.53 [95%CI, 0.33-0.85]) but not among those living alone (HR, 1.07 [95%CI, 0.66-1.73]; p-for-interaction, 0.04). A significant reduction of the composite cardiovascular outcome was observed among non-Black individuals regardless of living arrangement status. Conclusion: Intensive BP control was beneficial to reduce cardiovascular events among Black individuals living with others and non-Black individuals but not among Black individuals living alone. Our findings highlight a potentially important role of assessing living arrangements in tailored approaches to improve cardiovascular health among Black individuals.