Optimal SBP targets in routine clinical care

Journal of Hypertension
Lisanne A GitselsNicholas Steel

Abstract

Compare outcomes of intensive treatment of SBP to less than 120 mmHg versus standard treatment to less than 140 mmHg in the US clinical Systolic Blood Pressure Intervention Trial (SPRINT) with similar hypertensive patients managed in routine primary care in the United Kingdom. Hypertensive patients aged 50-90 without diabetes or chronic kidney disease (CKD) were selected in SPRINT and The Health Improvement Network (THIN) database. Patients were enrolled in 2010-2013 and followed-up to 2015 (SPRINT N = 4112; THIN N = 8631). Cox's proportional hazards regressions were fitted to estimate the hazard of all-cause mortality or CKD (main adverse effect) associated with intensive treatment, adjusted for sex, age, ethnicity, smoking, blood pressure, cardiovascular disease, aspirin, statin, number of antihypertensive drugs at baseline, change in number of antihypertensive drugs at trial entry, and clinical site. Almost half of the patients had intensive treatment (43-45%). In SPRINT, intensive treatment was associated with a decreased hazard of mortality of 0.63 (0.43-0.92), while in THIN with an increased hazard of 1.66 (1.28-2.15). In THIN, this effect was time-dependent. Intensive treatment was associated with an increased hazard of ...Continue Reading

References

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