ESC Congress 2021: Updates in Chronic Kidney Disease, Heart Failure, and Type 2 Diabetes - Episode 10

Results From the STEP Trial in China

A brief overview of the STEP trial and results from intensive blood-pressure control in elderly patients with hypertension.


Rajiv Agarwal, MD, MS: One of the noteworthy trials to me was STEP, which was a large trial of more than 8000 patients in China between the ages of 60 and 80, randomized to 2 different blood pressure targets. The blood pressure target was 110 to 130 mm Hg and 130 to 150 mm Hg in a population of patients between 60 and 80 years old. They showed that cardiovascular outcomes are incredibly improved by treatment to a lower blood pressure target of 110 to 130 mm Hg. Well, it is a population of Chinese patients: 90% are Han Chinese, so it validates the results of the SPRINT trial to China.

Basically, what we found in the SPRINT trial in the United States is similarly what is being found in China. The goal here is that the broad application of blood pressure lowering to huge population segments, even when they are 60 years of age or older, can show benefit against cardiovascular disease down the road. That’s really noteworthy. In particular, I was impressed with hospitalization for heart failure, which was reduced by more than three-quarters by simply lowering blood pressure, and that’s really remarkable. People ought to pay attention to blood pressure, especially in people who are elderly.

Transcript edited for clarity.