Min Jung Ko1, Ae Jung Jo1, Chan Mi Park1, Hyo Jeong Kim1, Yun Jung Kim1, Duk-Woo Park2. 1. Division for Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Republic of Korea. 2. Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine and National Evidence-based Healthcare Collaborating Agency, Seoul, Republic of Korea. Electronic address: dwpark@amc.seoul.kr.
Abstract
BACKGROUND: Blood pressure (BP) targets from the SPRINT (Systolic Blood Pressure Intervention Trial) differ from targets of the 2014 hypertension (HTN) recommendations of the Eighth Joint National Committee. OBJECTIVES: The goal of this study was to estimate the proportion of hypertensive adults with who would meet BP goals under the SPRINT criteria and under the 2014 recommendations, and to determine related effects on cardiovascular morbidity and mortality. METHODS: We used data from the Korean National Health and Nutrition Examination Survey of 2008 to 2013 (n = 13,346), as well as the Korean National Health Insurance Service health examinee cohort of 2007 (n = 67,965), to estimate the proportion of subjects meeting BP goals of each of the criteria. Using data from the Korean National Health Insurance Service health examinee cohort of 2007 (n = 67,965), we compared risks of major cardiovascular events (composite of nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes) associated with different BP control goals. RESULTS: A substantially lower proportion of hypertensive adults met BP goals of the SPRINT criteria compared with the 2014 recommendations (11.9% vs. 70.8%, respectively). Ten-year predicted cardiovascular risks were lowest in the intensive control group (below SPRINT BP goals), intermediate in the less-intensive group (above SPRINT goals but below 2014 recommendation goals), and highest in the uncontrolled group (above 2014 recommendations) (6.15%, 7.65%, and 9.39%, respectively; p < 0.001). After multivariable adjustment, the less-intensive and uncontrolled groups had a greater risk of major cardiovascular events (hazard ratios 1.17 and 1.62, respectively; p value for trend, <0.001) than the intensive group. CONCLUSIONS: Substantially fewer hypertensive adults would meet SPRINT BP goals than would meet 2014 recommendation goals. Stricter BP control is associated with a decreased risk of major cardiovascular events.
BACKGROUND: Blood pressure (BP) targets from the SPRINT (Systolic Blood Pressure Intervention Trial) differ from targets of the 2014 hypertension (HTN) recommendations of the Eighth Joint National Committee. OBJECTIVES: The goal of this study was to estimate the proportion of hypertensive adults with who would meet BP goals under the SPRINT criteria and under the 2014 recommendations, and to determine related effects on cardiovascular morbidity and mortality. METHODS: We used data from the Korean National Health and Nutrition Examination Survey of 2008 to 2013 (n = 13,346), as well as the Korean National Health Insurance Service health examinee cohort of 2007 (n = 67,965), to estimate the proportion of subjects meeting BP goals of each of the criteria. Using data from the Korean National Health Insurance Service health examinee cohort of 2007 (n = 67,965), we compared risks of major cardiovascular events (composite of nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes) associated with different BP control goals. RESULTS: A substantially lower proportion of hypertensive adults met BP goals of the SPRINT criteria compared with the 2014 recommendations (11.9% vs. 70.8%, respectively). Ten-year predicted cardiovascular risks were lowest in the intensive control group (below SPRINT BP goals), intermediate in the less-intensive group (above SPRINT goals but below 2014 recommendation goals), and highest in the uncontrolled group (above 2014 recommendations) (6.15%, 7.65%, and 9.39%, respectively; p < 0.001). After multivariable adjustment, the less-intensive and uncontrolled groups had a greater risk of major cardiovascular events (hazard ratios 1.17 and 1.62, respectively; p value for trend, <0.001) than the intensive group. CONCLUSIONS: Substantially fewer hypertensive adults would meet SPRINT BP goals than would meet 2014 recommendation goals. Stricter BP control is associated with a decreased risk of major cardiovascular events.
Authors: Neal A Chatterjee; Claudia U Chae; Eunjung Kim; M Vinayaga Moorthy; David Conen; Roopinder K Sandhu; Nancy R Cook; I-Min Lee; Christine M Albert Journal: JACC Heart Fail Date: 2017-06-14 Impact factor: 12.035
Authors: Paulus Kirchhof; Sylvia Haas; Pierre Amarenco; Susanne Hess; Marc Lambelet; Martin van Eickels; Alexander G G Turpie; A John Camm Journal: J Am Heart Assoc Date: 2020-02-21 Impact factor: 5.501