Intensive BP control improves projected survival by up to 3 years
Click Here to Manage Email Alerts
Compared with standard BP control, intensive BP control prolonged projected survival in patients at high CV risk without diabetes, but the absolute effect was strongest at younger ages, according to new data from the SPRINT trial.
According to research published in JAMA Cardiology, the differences in estimated residual survival in patients who underwent intensive BP control (target of < 120 mm Hg systolic) vs. standard BP control (target of < 140 mm Hg systolic) were as follows:
- at age 50 years, 37.3 years for intensive treatment vs. 34.4 years for standard care (difference, 2.9 years; 95% CI, 0.9-5);
- at age 65 years, 24.5 years for intensive treatment vs. 23.3 years for standard care (difference, 1.1 years; 95% CI, 0.1-2.1); and
- at age 80 years, 11.9 years for intensive treatment vs. 11.1 years for standard care (difference, 0.8 years; 95% CI, 0-1.6).
“When physicians discuss optimizing blood pressure, patients often wonder what benefits they may anticipate with intensive blood pressure control,” Muthiah Vaduganathan, MD, MPH, cardiologist at Brigham and Women’s Hospital Heart and Vascular Center, said in a press release. “That was the inspiration for our work: We’ve taken the data and reframed it to contextualize the results in a way that’s most meaningful to patients.”
Survival benefits and event-free survival
In other findings, mean survival benefits from intensive BP control compared with standard care ranged from 0.5 to 3 years, according to the study. Similarly, event-free survival benefits ranged from 0.2 to 3 years.
In addition, researchers determined that there was a consistent 4% to 9% relative benefit to residual survival in patients, regardless of age, and that benefits were more variable in event-free survival (3% to 15%).
“This age-based method also recognizes that the magnitude of treatment benefit may depend on the age of initiation, especially if therapies are intended for lifelong use,” the researchers wrote. “Younger patients have longer projected survival times and longer anticipated exposure to BP-lowering treatments over their lifetime. SPRINT was specifically designed to enrich enrollment of older adults, and events occurred across a broad range of ages, producing stable, age-specific estimates of residual survival.”
For this secondary analysis, researchers enrolled patients from the SPRINT trial (mean age at randomization, 68 years; 64% men; 59% non-Hispanic white) and estimated the age-based projected survival of patients receiving intensive BP control compared with standard control using baseline age rather than time from randomization.
Strong message for patients
“Given concerning declines in U.S. life expectancy for the last 3 years, these analyses help strengthen the public health message that population-wide BP control remains a critical strategy to improve life expectancy in the United States,” the researchers wrote. “Our analyses reaffirm the original SPRINT trial results and present them in alternative format that can be easily communicated to clinicians, patients and the public at large.” – by Scott Buzby
Disclosures: Vaduganathan reports he serves on advisory boards for Amgen, AstraZeneca, Baxter Healthcare, Bayer AG, Boehringer Ingelheim, Cytokinetics and Relypsa. Please see the study for all other authors’ relevant financial disclosures.
Read more about
Click Here to Manage Email Alerts