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Intensive BP Treatment & Subsequent CVD Risk

J Am Coll Cardiol; ePub 2018 Mar 7; Phillips, et al

Individuals with lower baseline cardiovascular disease (CVD) risk had more harm than benefit from intensive treatment of hypertension, while those with higher risk had more benefit. This according to a study that examined the effect of baseline 10-year CVD risk on primary outcome events and all-cause serious adverse events (SAEs) in the Systolic Pressure Intervention Trial (SPRINT). Stratifying by quartiles of baseline 10-year CVD risk, Cox proportional hazards models were used to examine the associations of treatment group with primary outcomes events and SAEs. Researchers found:

  • Within each quartile, there was a lower rate of primary outcome vents in the intensive treatment group, with no differences in all-cause SAEs.
  • The number needed to treat to prevent primary outcomes decreased from 91 to 30 from the first to fourth quartiles.
  • The number need to harm for all-cause SAEs increased from 62 to 250.
  • There was significantly increasing benefit-to-harm ratio for the first, second, third, and fourth quartile, respectively.

Citation:

Phillips R, Xu J, Peterson LE, et al. Impact of cardiovascular risk on the relative benefit and harm of intensive treatment of hypertension. [Published online ahead of print March 7, 2018]. J Am Coll Cardiol. doi:10.1016/j.jacc.2018.01.074.

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