Highlights of ESC Congress 2021: STEP Study

STEP study, presented by Professor Jun Cai (Chinese Academy of Medical Sciences, Beijing, China) in a Hot Line session on 30th August. The STEP study investigated whether intensive treatment (systolic blood pressure [SBP] target below 130 mmHg but no lower than 110 mmHg) could reduce the risk of cardiovascular (CV) events compared with standard treatment (SBP target 130–150 mmHg). In total, 8,511 patients aged 60–80 years with SBP 140–190 mmHg during three screening visits or who were taking antihypertensive medication were randomized The primary outcome was a composite of stroke, acute coronary syndrome (ACS), acute decompensated heart failure, coronary revascularization, atrial fibrillation, or death from CV causes. Secondary outcomes included the individual components of the primary endpoint, death from any cause, major adverse cardiac events, and renal outcomes (a decrease in renal function or the development of end-stage renal disease) Over a median follow-up period of 3.34 years, the mean reduction in SBP from baseline was 19.4 mmHg with intensive treatment and 10.1 mmHg with standard treatment. Intensive treatment was associated with a 26% relative risk reduction in the number of primary outcome events compared with standard treatment Intensive treatment was also associated with a 33% lower relative risk of stroke and a 33% lower relative risk of ACS The incidence of safety outcomes and renal outcomes did not differ between the groups, except for hypotension, which occurred in 3.4% of patients in the intensive group and 2.6% in the standard group (p=0.03). Thus, Active control of SBP to below 130 mmHg in older hypertensive patients, as compared with below 150 mmHg, resulted in a lower incidence of major CV events, with no increase in renal injuries. Disclaimer: Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any scientific information shared by the HCP on the ­­­STAR UPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this website.