Table 2.
Association of serum parathyroid hormone with cardiovascular events, heart failure events, and mortality in SPRINT participants with CKD
| Outcome | PTH Q1 | PTH Q2 | PTH Q3 | PTH Q4 | Per 2-Fold Higher PTH | P Value |
|---|---|---|---|---|---|---|
| HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | ||
| Range, pg/ml | 4–35 | 36–48 | 49–67 | 68–409 | ||
| Cardiovascular events, n (%) | 56 (10) | 52 (8) | 59 (10) | 94 (15) | 261 (11) | |
| Model 1 | Reference | 0.76 (0.51 to 1.13) | 0.98 (0.67 to 1.44) | 1.67 (1.17 to 2.39) | 1.50 (1.25 to 1.80) | <0.001 |
| Model 2 | Reference | 0.75 (0.50 to 1.11) | 0.88 (0.60 to 1.31) | 1.38 (0.94 to 2.03) | 1.29 (1.06 to 1.57) | 0.01 |
| Heart failure, n (%) | 17 (3) | 18 (3) | 22 (4) | 45 (7) | 102 (4) | |
| Model 1 | Reference | 0.88 (0.44 to 1.75) | 1.07 (0.55 to 2.10) | 2.17 (1.20 to 4.07) | 1.80 (1.35 to 2.40) | <0.001 |
| Model 2 | Reference | 0.77 (0.38 to 1.56) | 0.90 (0.45 to 1.82) | 1.37 (0.71 to 2.73) | 1.32 (0.96 to 1.83) | 0.09 |
| All-cause mortality, n (%) | 39 (7) | 35 (6) | 40 (7) | 65 (7) | 179 (8) | |
| Model 1 | Reference | 0.65 (0.40 to 1.05) | 0.87 (0.55 to 1.38) | 1.31 (0.86 to 2.01) | 1.34 (1.08 to 1.67) | 0.01 |
| Model 2 | Reference | 0.59 (0.36 to 0.95) | 0.73 (0.46 to 1.17) | 0.90 (0.57 to 1.43) | 1.04 (0.82 to 1.31) | 0.74 |
Model 1: adjusted for age, sex, race, and randomized treatment arm. Model 2: adjusted for model 1 variables plus eGFR (using creatinine and cystatin C), urine albumin-to-creatinine ratio, prevalent cardiovascular disease, prevalent heart failure, systolic BP, number of antihypertensives at baseline, smoking, body mass index, total cholesterol, and HDL cholesterol. SPRINT, Systolic Blood Pressure Intervention Trial; PTH, parathyroid hormone; Q, quartile; HR, hazard ratio; 95% CI, 95% confidence interval.