14 Jun Observational Study Confirms SPRINT Trials’ Link Between Lower BP Target and Fewer CV Events
MedicalResearch.com Interview with:
Duk-Woo Park, MD, PhD
Dr. Duk Woo Park
Division of Cardiology, Asan Medical Center
University of Ulsan College of Medicine and National Evidence-based Healthcare Collaborating Agency
Seoul, Republic of Korea
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Currently, less restrictive blood pressure (BP) target by the 2014 hypertension guidelines (JNC-8) and more intensive BP target of the SPRINT is now conflicting, which causes uncertainty and confusion among clinicians. In our study, the proportion of persons who would meet the SPRINT BP goals is substantially less than those who would meet the 2014 guideline blood pressure goals. There is a positive association between the risk of major cardiovascular events and increasing levels of BP control status under different 2014 guideline and SPRINT criteria. Our study reconfirmed the findings of the SPRINT trials in real-world population.
MedicalResearch.com: What should readers take away from your report?
Response: Although we found a positive association between lower levels of blood pressure and lower risks of cardiovascular events, overall findings are explorative and hypothesis-generating because our study is observational. Therefore, our observations can’t support the idea that lowering blood pressure will directly result in lower rates of cardiovascular events. In addition, BP targets and actual BP lowering may not be equivalent in practice. Further investigations are required to determine the applicability and the potential impact of the results of SPRINT to the less restrictive general population.
And, I think that beyond the blood pressure target per se, several important factors are considered to inform decision-making for BP-lowering therapy in the contemporary medical setting (for instance, an integrated and systematic assessment of combined risk factors and baseline cardiovascular risk, concomitant preventive medical therapies, clinician-patient discussions of the potential benefits and harms, or the clinical judgment of the treating physicians).
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Our findings should be re-assssed in other ethnics or other population because the baseline risk factors, characteristics, or the expected events of cardiovascular events might substantially differ in diverse geographic regions or diverse ethnic populations.
MedicalResearch.com: Is there anything else you would like to add?
Response: Currently, less restrictive blood pressure target by the 2014 hypertension guidelines (JNC-8) and more intensive BP target of the SPRINT is now conflicting, which causes uncertainty and confusion among clinicians. Therefore, more updated guideline-recommendation adopting the recent release of compelling trials, such as the SPRINT or HOPE-3, would be required to guide decision-making for optimal management of hypertension in the routine and real-world practice.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Citation:
Ko M, Jo A, Park C, Kim H, Kim Y, Park D. Level of Blood Pressure Control and Cardiovascular Events: SPRINT Criteria Versus the 2014 Hypertension Recommendations. J Am Coll Cardiol. 2016;67(24):2821-2831. doi:10.1016/j.jacc.2016.03.572.
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Last Updated on June 14, 2016 by Marie Benz MD FAAD