Intensive systolic BP lowering projected to prevent 100,000 US deaths annually

More than 100,000 deaths could be prevented annually by aggressively lowering systolic BP to 120 mm Hg or less, according to data presented at the American Heart Association’s Council on Hypertension 2016 Scientific Sessions.

Results of the SPRINT trial, released in November, showed that patients who participated in an intensive systolic BP lowering program reduced their likelihood of all-cause mortality by 27%.

“Standard medical practice generally aims to reduce adults’ systolic [BP] to less than 140 (mm Hg),” Holly Kramer, MD, MPH, associate professor of public health sciences and medicine at Loyola University Medical Center in Maywood, Illinois, said in a press release. “Our study sought to find out what the reduction in risk of death would be if all U.S. adults who met criteria for the SPRINT trial were treated with intensive systolic [BP] lowering.”

Holly Kramer

The SPRINT trial randomly assigned 9,361 adult patients aged at least 50 years with systolic BP 130 mm Hg to 180 mm Hg, and high risk for CVD, diabetes or stroke to intensive systolic BP lowering ( 120 mm Hg) or standard systolic BP lowering ( 140 mm Hg).

The National Health and Nutrition Examination Survey 1999-2006 was used to create the criteria for the SPRINT trial.

Adult patients with diabetes, stroke, more than 1 g per day proteinuria, HF, on dialysis, or estimated glomerular filtration rate less than 20 mL/min/1.73 m² were excluded from the trial.

Approximately 18.1 million adults in the United States (mean age, 68.6 years; 83.2% white) met the necessary criteria for the SPRINT trial, 7.4 million of whom were taking BP-lowering medication.

The researchers determined the annual mortality rate of the eligibility cohort was 2.2% (95% CI, 1.9-2.5), and approximately 107,500 (95% CI, 93,300-121,200) deaths per year could be prevented with intensive systolic BP lowering.

Kramer and colleagues also found that in adult patients with systolic BP at least 145 mm Hg, the annual mortality rate was 2.5% (95% CI, 2.1-3) and intensive systolic BP lowering would prevent 60,900 deaths (95% CI, 26,500-76,800) annually.

“The SPRINT clinical trial clearly showed that intensive systolic [BP] lowering lowers risk of death from all causes and will save lives among adults aged 50 years and older,” Kramer said in the release. – by Dave Quaile

Reference:

Kramer H, et al. Abstract 241. Presented at: American Heart Association’s Council on Hypertension Scientific Sessions; Sept. 14-16, 2016; Orlando, Fla.

Disclosure: Kramer reports no relevant financial disclosures.