Proportion and Characteristics of US Adults Who May Be Eligible From Additional Blood Pressure Lowering Based on Absolute Risk
BACKGROUND<br/> The Systolic Blood Pressure Intervention Trial (SPRINT) and the Heart Outcomes Prevention Evaluation 3 (HOPE-3) trial demonstrated the merits of blood pressure (BP) lowering to reduce cardiovascular events in intermediate to high cardiovascular risk adults. However, the populat...
| Main Authors: | , , |
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| Format: | Journal article |
| Language: | English |
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Oxford University Press
2016
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| _version_ | 1797056733666869248 |
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| author | Odutayo, A Tennankore, K Emdin, C |
| author_facet | Odutayo, A Tennankore, K Emdin, C |
| author_sort | Odutayo, A |
| collection | OXFORD |
| description | BACKGROUND<br/> The Systolic Blood Pressure Intervention Trial (SPRINT) and the Heart Outcomes Prevention Evaluation 3 (HOPE-3) trial demonstrated the merits of blood pressure (BP) lowering to reduce cardiovascular events in intermediate to high cardiovascular risk adults. However, the population impact of an absolute risk-based strategy for BP lowering remains unclear. <br/><br/>METHODS<br/> We examined 3 treatment thresholds using the National Health and Nutrition Examination Survey. First, the JNC8 guideline was used to determine treatment goals. Second, adults with a systolic BP (SBP) of 130 mm Hg and high cardiovascular risk (based on eligibility for SPRINT) were considered eligible for additional BP lowering. Finally, we combined the treatment threshold for high-risk adults with an SBP treatment threshold of 140 mm Hg for intermediate-risk adults that met the eligibility criteria for HOPE-3. <br/><br/>RESULTS<br/> Under the JNC8 guideline, 78.0% of adults ≥50 years were at target while 22.0% were eligible for additional BP lowering. If an SBP treatment threshold of 130 mm Hg was used for adults at high cardiovascular risk, 31.1% would be eligible for additional BP lowering (an increase of 8.1 million). If an SBP threshold of 140 mm Hg was additionally used for adults at intermediate risk, 31.4% of adults would be eligible for BP lowering (an increase of 8.3 million). The proportion of adults eligible for BP lowering with established coronary artery disease decreased with the risk-based strategies. <br/><br/>CONCLUSION<br/> An absolute risk treatment strategy would modestly increase the proportion of adults eligible for BP lowering. |
| first_indexed | 2024-03-06T19:26:47Z |
| format | Journal article |
| id | oxford-uuid:1c0330b9-0a6e-423d-92b3-d81a2ac2eb97 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:26:47Z |
| publishDate | 2016 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:1c0330b9-0a6e-423d-92b3-d81a2ac2eb972022-03-26T11:03:26ZProportion and Characteristics of US Adults Who May Be Eligible From Additional Blood Pressure Lowering Based on Absolute RiskJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1c0330b9-0a6e-423d-92b3-d81a2ac2eb97EnglishSymplectic Elements at OxfordOxford University Press2016Odutayo, ATennankore, KEmdin, CBACKGROUND<br/> The Systolic Blood Pressure Intervention Trial (SPRINT) and the Heart Outcomes Prevention Evaluation 3 (HOPE-3) trial demonstrated the merits of blood pressure (BP) lowering to reduce cardiovascular events in intermediate to high cardiovascular risk adults. However, the population impact of an absolute risk-based strategy for BP lowering remains unclear. <br/><br/>METHODS<br/> We examined 3 treatment thresholds using the National Health and Nutrition Examination Survey. First, the JNC8 guideline was used to determine treatment goals. Second, adults with a systolic BP (SBP) of 130 mm Hg and high cardiovascular risk (based on eligibility for SPRINT) were considered eligible for additional BP lowering. Finally, we combined the treatment threshold for high-risk adults with an SBP treatment threshold of 140 mm Hg for intermediate-risk adults that met the eligibility criteria for HOPE-3. <br/><br/>RESULTS<br/> Under the JNC8 guideline, 78.0% of adults ≥50 years were at target while 22.0% were eligible for additional BP lowering. If an SBP treatment threshold of 130 mm Hg was used for adults at high cardiovascular risk, 31.1% would be eligible for additional BP lowering (an increase of 8.1 million). If an SBP threshold of 140 mm Hg was additionally used for adults at intermediate risk, 31.4% of adults would be eligible for BP lowering (an increase of 8.3 million). The proportion of adults eligible for BP lowering with established coronary artery disease decreased with the risk-based strategies. <br/><br/>CONCLUSION<br/> An absolute risk treatment strategy would modestly increase the proportion of adults eligible for BP lowering. |
| spellingShingle | Odutayo, A Tennankore, K Emdin, C Proportion and Characteristics of US Adults Who May Be Eligible From Additional Blood Pressure Lowering Based on Absolute Risk |
| title | Proportion and Characteristics of US Adults Who May Be Eligible From Additional Blood Pressure Lowering Based on Absolute Risk |
| title_full | Proportion and Characteristics of US Adults Who May Be Eligible From Additional Blood Pressure Lowering Based on Absolute Risk |
| title_fullStr | Proportion and Characteristics of US Adults Who May Be Eligible From Additional Blood Pressure Lowering Based on Absolute Risk |
| title_full_unstemmed | Proportion and Characteristics of US Adults Who May Be Eligible From Additional Blood Pressure Lowering Based on Absolute Risk |
| title_short | Proportion and Characteristics of US Adults Who May Be Eligible From Additional Blood Pressure Lowering Based on Absolute Risk |
| title_sort | proportion and characteristics of us adults who may be eligible from additional blood pressure lowering based on absolute risk |
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