This Week in Cardiology Oct 24 2025 This Week in Cardiology
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Oct 24, 2025 Explore the innovative PREVENT score for hypertension risk assessment and its application in the SPRINT trial. Delve into the mechanism of action of GLP-1 drugs, examining whether weight loss drives cardiovascular benefits. Discover insights on the impact of CAD phenotype on statin efficacy and uncover flaws in using hospitalization endpoints to evaluate heart failure trials. John Mandrola highlights the need for nuanced approaches and evidence-based decisions in cardiology.
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PREVENT Reclassifies SPRINT Risk
- The PREVENT score reclassifies most SPRINT patients to lower 10-year risk compared with the PCE, removing race and adding kidney, A1C, BMI, albumin and zip code.
- Using PREVENT shifts many patients out of treatment thresholds and reduces projected treatment-eligible numbers despite consistent relative benefits from intensive BP control.
Absolute Benefit Varies By PREVENT Risk
- Intensive BP control (target 120 mmHg) showed consistent relative risk reductions across PREVENT risk tiers but varied absolute benefit: 0.2%, 1.5%, and 2.4% over four years.
- Harms (syncope, hypotension, AKI) rose too, with intermediate-risk patients having unexpectedly the highest absolute adverse-event increase.
Use Main Trial Data And Patient Preferences
- Lean on the main SPRINT trial results for SPRINT-like patients rather than overinterpreting subgroup reanalyses like PREVENT post hoc splits.
- Tailor decisions to patient preferences, explaining absolute risks and benefits rather than only relying on reclassified risk scores.