Estimated Population Health Benefits of Intensive Systolic Blood Pressure Treatment Among SPRINT-Eligible US Adults
Abstract Background The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated an intensive (
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| Veröffentlicht in: | American journal of hypertension 2023-08, Vol.36 (9), p.498-508 |
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| creator | Derington, Catherine G Bress, Adam P Berchie, Ransmond O Herrick, Jennifer S Shen, Jincheng Ying, Jian Greene, Tom Tajeu, Gabriel S Sakhuja, Swati Ruiz-Negrón, Natalia Zhang, Yiyi Howard, George Levitan, Emily B Muntner, Paul Safford, Monika M Whelton, Paul K Weintraub, William S Moran, Andrew E Bellows, Brandon K |
| description | Abstract
Background
The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated an intensive ( |
| doi_str_mv | 10.1093/ajh/hpad047 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10403972</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ajh/hpad047</oup_id><sourcerecordid>2830667398</sourcerecordid><originalsourceid>FETCH-LOGICAL-c413t-183ceb491c1947c5008fad52e15f62a8636d028407d920770ec19353143ed61b3</originalsourceid><addsrcrecordid>eNp9kUFv1DAQhS0EokvhxB35hJBQ6NhO7OSEttVCV6qgYrdny5tMdl05cbCdSv33GO1SwYXTHOabN-_pEfKWwScGjbgw94eLw2Q6KNUzsmBNyQrFefWcLKBuqkKBZGfkVYz3AFBKyV6SM6GEqkvFFySuYrKDSdjRWz_NziTrR3qNxqUDvcQRe5si9T1djwnHaB-Qbh5j8s629NJ5n88CxjgHpNuAJg04Jroc_Linm9sf62_bYuXs3u4c0rsNXXazS_E1edEbF_HNaZ6Tuy-r7dV1cfP96_pqeVO0JROpYLVocVc2rM2ZVFsB1L3pKo6s6iU3tRSyA16XoLqGg1KAGRSVYKXATrKdOCefj7rTvBuwa7O1YJyeQg4cHrU3Vv-7Ge1B7_2DZlCCaBTPCh9OCsH_nDEmPdjYonNmRD9HzWsBUirR1Bn9eETb4GMM2D_9YaB_96RzT_rUU6bf_W3tif1TTAbeHwE_T_9V-gV3eZ0u</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2830667398</pqid></control><display><type>article</type><title>Estimated Population Health Benefits of Intensive Systolic Blood Pressure Treatment Among SPRINT-Eligible US Adults</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Derington, Catherine G ; Bress, Adam P ; Berchie, Ransmond O ; Herrick, Jennifer S ; Shen, Jincheng ; Ying, Jian ; Greene, Tom ; Tajeu, Gabriel S ; Sakhuja, Swati ; Ruiz-Negrón, Natalia ; Zhang, Yiyi ; Howard, George ; Levitan, Emily B ; Muntner, Paul ; Safford, Monika M ; Whelton, Paul K ; Weintraub, William S ; Moran, Andrew E ; Bellows, Brandon K</creator><creatorcontrib>Derington, Catherine G ; Bress, Adam P ; Berchie, Ransmond O ; Herrick, Jennifer S ; Shen, Jincheng ; Ying, Jian ; Greene, Tom ; Tajeu, Gabriel S ; Sakhuja, Swati ; Ruiz-Negrón, Natalia ; Zhang, Yiyi ; Howard, George ; Levitan, Emily B ; Muntner, Paul ; Safford, Monika M ; Whelton, Paul K ; Weintraub, William S ; Moran, Andrew E ; Bellows, Brandon K</creatorcontrib><description>Abstract
Background
The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated an intensive (<120 mm Hg) vs. standard (<140 mm Hg) systolic blood pressure (SBP) goal lowered cardiovascular disease (CVD) risk. Estimating the effect of intensive SBP lowering among SPRINT-eligible adults most likely to benefit can guide implementation efforts.
Methods
We studied SPRINT participants and SPRINT-eligible participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study and National Health and Nutrition Examination Surveys (NHANES). A published algorithm of predicted CVD benefit with intensive SBP treatment was used to categorize participants into low, medium, or high predicted benefit. CVD event rates were estimated with intensive and standard treatment.
Results
Median age was 67.0, 72.0, and 64.0 years in SPRINT, SPRINT-eligible REGARDS, and SPRINT-eligible NHANES participants, respectively. The proportion with high predicted benefit was 33.0% in SPRINT, 39.0% in SPRINT-eligible REGARDS, and 23.5% in SPRINT-eligible NHANES. The estimated difference in CVD event rate (standard minus intensive) was 7.0 (95% confidence interval [CI] 3.4–10.7), 8.4 (95% CI 8.2–8.5), and 6.1 (95% CI 5.9–6.3) per 1,000 person-years in SPRINT, SPRINT-eligible REGARDS participants, and SPRINT-eligible NHANES participants, respectively (median 3.2-year follow-up). Intensive SBP treatment could prevent 84,300 (95% CI 80,800–87,920) CVD events per year in 14.1 million SPRINT-eligible US adults; 29,400 and 28,600 would be in 7.0 million individuals with medium or high predicted benefit, respectively.
Conclusions
Most of the population health benefit from intensive SBP goals could be achieved by treating those characterized by a previously published algorithm as having medium or high predicted benefit.
Graphical abstract
Graphical Abstract
This graphical abstract is also available at Tidbit: https://tidbitapp.io/tidbits/estimated-population-health-benefits-of-intensive-systolic-blood-pressure-treatment-among-sprint-eligible-us-adults.</description><identifier>ISSN: 0895-7061</identifier><identifier>ISSN: 1941-7225</identifier><identifier>EISSN: 1941-7225</identifier><identifier>DOI: 10.1093/ajh/hpad047</identifier><identifier>PMID: 37378472</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Adult ; Antihypertensive Agents - pharmacology ; Antihypertensive Agents - therapeutic use ; Blood Pressure ; Editor's Choice ; Humans ; Hypertension - diagnosis ; Hypertension - drug therapy ; Hypertension - epidemiology ; Nutrition Surveys ; Original Contributions ; Risk Factors</subject><ispartof>American journal of hypertension, 2023-08, Vol.36 (9), p.498-508</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2023</rights><rights>The Author(s) 2023. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c413t-183ceb491c1947c5008fad52e15f62a8636d028407d920770ec19353143ed61b3</citedby><cites>FETCH-LOGICAL-c413t-183ceb491c1947c5008fad52e15f62a8636d028407d920770ec19353143ed61b3</cites><orcidid>0000-0002-2225-383X ; 0000-0001-7382-4607 ; 0000-0002-4711-5492</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37378472$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Derington, Catherine G</creatorcontrib><creatorcontrib>Bress, Adam P</creatorcontrib><creatorcontrib>Berchie, Ransmond O</creatorcontrib><creatorcontrib>Herrick, Jennifer S</creatorcontrib><creatorcontrib>Shen, Jincheng</creatorcontrib><creatorcontrib>Ying, Jian</creatorcontrib><creatorcontrib>Greene, Tom</creatorcontrib><creatorcontrib>Tajeu, Gabriel S</creatorcontrib><creatorcontrib>Sakhuja, Swati</creatorcontrib><creatorcontrib>Ruiz-Negrón, Natalia</creatorcontrib><creatorcontrib>Zhang, Yiyi</creatorcontrib><creatorcontrib>Howard, George</creatorcontrib><creatorcontrib>Levitan, Emily B</creatorcontrib><creatorcontrib>Muntner, Paul</creatorcontrib><creatorcontrib>Safford, Monika M</creatorcontrib><creatorcontrib>Whelton, Paul K</creatorcontrib><creatorcontrib>Weintraub, William S</creatorcontrib><creatorcontrib>Moran, Andrew E</creatorcontrib><creatorcontrib>Bellows, Brandon K</creatorcontrib><title>Estimated Population Health Benefits of Intensive Systolic Blood Pressure Treatment Among SPRINT-Eligible US Adults</title><title>American journal of hypertension</title><addtitle>Am J Hypertens</addtitle><description>Abstract
Background
The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated an intensive (<120 mm Hg) vs. standard (<140 mm Hg) systolic blood pressure (SBP) goal lowered cardiovascular disease (CVD) risk. Estimating the effect of intensive SBP lowering among SPRINT-eligible adults most likely to benefit can guide implementation efforts.
Methods
We studied SPRINT participants and SPRINT-eligible participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study and National Health and Nutrition Examination Surveys (NHANES). A published algorithm of predicted CVD benefit with intensive SBP treatment was used to categorize participants into low, medium, or high predicted benefit. CVD event rates were estimated with intensive and standard treatment.
Results
Median age was 67.0, 72.0, and 64.0 years in SPRINT, SPRINT-eligible REGARDS, and SPRINT-eligible NHANES participants, respectively. The proportion with high predicted benefit was 33.0% in SPRINT, 39.0% in SPRINT-eligible REGARDS, and 23.5% in SPRINT-eligible NHANES. The estimated difference in CVD event rate (standard minus intensive) was 7.0 (95% confidence interval [CI] 3.4–10.7), 8.4 (95% CI 8.2–8.5), and 6.1 (95% CI 5.9–6.3) per 1,000 person-years in SPRINT, SPRINT-eligible REGARDS participants, and SPRINT-eligible NHANES participants, respectively (median 3.2-year follow-up). Intensive SBP treatment could prevent 84,300 (95% CI 80,800–87,920) CVD events per year in 14.1 million SPRINT-eligible US adults; 29,400 and 28,600 would be in 7.0 million individuals with medium or high predicted benefit, respectively.
Conclusions
Most of the population health benefit from intensive SBP goals could be achieved by treating those characterized by a previously published algorithm as having medium or high predicted benefit.
Graphical abstract
Graphical Abstract
This graphical abstract is also available at Tidbit: https://tidbitapp.io/tidbits/estimated-population-health-benefits-of-intensive-systolic-blood-pressure-treatment-among-sprint-eligible-us-adults.</description><subject>Adult</subject><subject>Antihypertensive Agents - pharmacology</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Blood Pressure</subject><subject>Editor's Choice</subject><subject>Humans</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - drug therapy</subject><subject>Hypertension - epidemiology</subject><subject>Nutrition Surveys</subject><subject>Original Contributions</subject><subject>Risk Factors</subject><issn>0895-7061</issn><issn>1941-7225</issn><issn>1941-7225</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFv1DAQhS0EokvhxB35hJBQ6NhO7OSEttVCV6qgYrdny5tMdl05cbCdSv33GO1SwYXTHOabN-_pEfKWwScGjbgw94eLw2Q6KNUzsmBNyQrFefWcLKBuqkKBZGfkVYz3AFBKyV6SM6GEqkvFFySuYrKDSdjRWz_NziTrR3qNxqUDvcQRe5si9T1djwnHaB-Qbh5j8s629NJ5n88CxjgHpNuAJg04Jroc_Linm9sf62_bYuXs3u4c0rsNXXazS_E1edEbF_HNaZ6Tuy-r7dV1cfP96_pqeVO0JROpYLVocVc2rM2ZVFsB1L3pKo6s6iU3tRSyA16XoLqGg1KAGRSVYKXATrKdOCefj7rTvBuwa7O1YJyeQg4cHrU3Vv-7Ge1B7_2DZlCCaBTPCh9OCsH_nDEmPdjYonNmRD9HzWsBUirR1Bn9eETb4GMM2D_9YaB_96RzT_rUU6bf_W3tif1TTAbeHwE_T_9V-gV3eZ0u</recordid><startdate>20230805</startdate><enddate>20230805</enddate><creator>Derington, Catherine G</creator><creator>Bress, Adam P</creator><creator>Berchie, Ransmond O</creator><creator>Herrick, Jennifer S</creator><creator>Shen, Jincheng</creator><creator>Ying, Jian</creator><creator>Greene, Tom</creator><creator>Tajeu, Gabriel S</creator><creator>Sakhuja, Swati</creator><creator>Ruiz-Negrón, Natalia</creator><creator>Zhang, Yiyi</creator><creator>Howard, George</creator><creator>Levitan, Emily B</creator><creator>Muntner, Paul</creator><creator>Safford, Monika M</creator><creator>Whelton, Paul K</creator><creator>Weintraub, William S</creator><creator>Moran, Andrew E</creator><creator>Bellows, Brandon K</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2225-383X</orcidid><orcidid>https://orcid.org/0000-0001-7382-4607</orcidid><orcidid>https://orcid.org/0000-0002-4711-5492</orcidid></search><sort><creationdate>20230805</creationdate><title>Estimated Population Health Benefits of Intensive Systolic Blood Pressure Treatment Among SPRINT-Eligible US Adults</title><author>Derington, Catherine G ; Bress, Adam P ; Berchie, Ransmond O ; Herrick, Jennifer S ; Shen, Jincheng ; Ying, Jian ; Greene, Tom ; Tajeu, Gabriel S ; Sakhuja, Swati ; Ruiz-Negrón, Natalia ; Zhang, Yiyi ; Howard, George ; Levitan, Emily B ; Muntner, Paul ; Safford, Monika M ; Whelton, Paul K ; Weintraub, William S ; Moran, Andrew E ; Bellows, Brandon K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c413t-183ceb491c1947c5008fad52e15f62a8636d028407d920770ec19353143ed61b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>Antihypertensive Agents - pharmacology</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Blood Pressure</topic><topic>Editor's Choice</topic><topic>Humans</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - drug therapy</topic><topic>Hypertension - epidemiology</topic><topic>Nutrition Surveys</topic><topic>Original Contributions</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Derington, Catherine G</creatorcontrib><creatorcontrib>Bress, Adam P</creatorcontrib><creatorcontrib>Berchie, Ransmond O</creatorcontrib><creatorcontrib>Herrick, Jennifer S</creatorcontrib><creatorcontrib>Shen, Jincheng</creatorcontrib><creatorcontrib>Ying, Jian</creatorcontrib><creatorcontrib>Greene, Tom</creatorcontrib><creatorcontrib>Tajeu, Gabriel S</creatorcontrib><creatorcontrib>Sakhuja, Swati</creatorcontrib><creatorcontrib>Ruiz-Negrón, Natalia</creatorcontrib><creatorcontrib>Zhang, Yiyi</creatorcontrib><creatorcontrib>Howard, George</creatorcontrib><creatorcontrib>Levitan, Emily B</creatorcontrib><creatorcontrib>Muntner, Paul</creatorcontrib><creatorcontrib>Safford, Monika M</creatorcontrib><creatorcontrib>Whelton, Paul K</creatorcontrib><creatorcontrib>Weintraub, William S</creatorcontrib><creatorcontrib>Moran, Andrew E</creatorcontrib><creatorcontrib>Bellows, Brandon K</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of hypertension</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Derington, Catherine G</au><au>Bress, Adam P</au><au>Berchie, Ransmond O</au><au>Herrick, Jennifer S</au><au>Shen, Jincheng</au><au>Ying, Jian</au><au>Greene, Tom</au><au>Tajeu, Gabriel S</au><au>Sakhuja, Swati</au><au>Ruiz-Negrón, Natalia</au><au>Zhang, Yiyi</au><au>Howard, George</au><au>Levitan, Emily B</au><au>Muntner, Paul</au><au>Safford, Monika M</au><au>Whelton, Paul K</au><au>Weintraub, William S</au><au>Moran, Andrew E</au><au>Bellows, Brandon K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Estimated Population Health Benefits of Intensive Systolic Blood Pressure Treatment Among SPRINT-Eligible US Adults</atitle><jtitle>American journal of hypertension</jtitle><addtitle>Am J Hypertens</addtitle><date>2023-08-05</date><risdate>2023</risdate><volume>36</volume><issue>9</issue><spage>498</spage><epage>508</epage><pages>498-508</pages><issn>0895-7061</issn><issn>1941-7225</issn><eissn>1941-7225</eissn><abstract>Abstract
Background
The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated an intensive (<120 mm Hg) vs. standard (<140 mm Hg) systolic blood pressure (SBP) goal lowered cardiovascular disease (CVD) risk. Estimating the effect of intensive SBP lowering among SPRINT-eligible adults most likely to benefit can guide implementation efforts.
Methods
We studied SPRINT participants and SPRINT-eligible participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study and National Health and Nutrition Examination Surveys (NHANES). A published algorithm of predicted CVD benefit with intensive SBP treatment was used to categorize participants into low, medium, or high predicted benefit. CVD event rates were estimated with intensive and standard treatment.
Results
Median age was 67.0, 72.0, and 64.0 years in SPRINT, SPRINT-eligible REGARDS, and SPRINT-eligible NHANES participants, respectively. The proportion with high predicted benefit was 33.0% in SPRINT, 39.0% in SPRINT-eligible REGARDS, and 23.5% in SPRINT-eligible NHANES. The estimated difference in CVD event rate (standard minus intensive) was 7.0 (95% confidence interval [CI] 3.4–10.7), 8.4 (95% CI 8.2–8.5), and 6.1 (95% CI 5.9–6.3) per 1,000 person-years in SPRINT, SPRINT-eligible REGARDS participants, and SPRINT-eligible NHANES participants, respectively (median 3.2-year follow-up). Intensive SBP treatment could prevent 84,300 (95% CI 80,800–87,920) CVD events per year in 14.1 million SPRINT-eligible US adults; 29,400 and 28,600 would be in 7.0 million individuals with medium or high predicted benefit, respectively.
Conclusions
Most of the population health benefit from intensive SBP goals could be achieved by treating those characterized by a previously published algorithm as having medium or high predicted benefit.
Graphical abstract
Graphical Abstract
This graphical abstract is also available at Tidbit: https://tidbitapp.io/tidbits/estimated-population-health-benefits-of-intensive-systolic-blood-pressure-treatment-among-sprint-eligible-us-adults.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>37378472</pmid><doi>10.1093/ajh/hpad047</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-2225-383X</orcidid><orcidid>https://orcid.org/0000-0001-7382-4607</orcidid><orcidid>https://orcid.org/0000-0002-4711-5492</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0895-7061 |
| ispartof | American journal of hypertension, 2023-08, Vol.36 (9), p.498-508 |
| issn | 0895-7061 1941-7225 1941-7225 |
| language | eng |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Alma/SFX Local Collection |
| subjects | Adult Antihypertensive Agents - pharmacology Antihypertensive Agents - therapeutic use Blood Pressure Editor's Choice Humans Hypertension - diagnosis Hypertension - drug therapy Hypertension - epidemiology Nutrition Surveys Original Contributions Risk Factors |
| title | Estimated Population Health Benefits of Intensive Systolic Blood Pressure Treatment Among SPRINT-Eligible US Adults |
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