Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

BMI Measurements and Intensive BP Management

Am J Med; ePub 2019 Feb 2; Oxlund, et al

Among high-risk older individuals from the Systolic Blood Pressure Intervention Trial (SPRINT), the overall efficacy and safety of intensive blood pressure (BP) lowering did not appear to be modified by baseline body mass index (BMI). The SPRINT trial included 9,361 individuals aged ≥50 years at high cardiovascular (CV) risk, without diabetes mellitus, and a systolic BP 130-180 mmHg. Participants were randomized to intensive vs standard antihypertensive treatment and evaluated for the primary composite efficacy endpoint of acute coronary syndromes, stroke, heart failure, or CV death. Researchers sought to determine the relationship between BMI, response to intensive BP lowering, and clinical outcomes. They found:

  • BMI measurements could be calculated for 9,284 (99.2%) individuals; mean BMI was similar between 2 treatment groups.
  • Median follow-up was 3.3 years.
  • BMI had a significant, J-shaped association with risk of all-cause mortality, stroke, and serious adverse events, but these were no longer significant after accounting for key clinical factors.
  • Intensive BP lowering reduced the primary efficacy endpoint consistently across the BMI spectrum.

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AHA Statement: Accurate Measurement of BP, Hypertension; ePub 2019 Mar 4; Muntner, et al

Is Adding Aspirin to Warfarin Therapy Beneficial? , JAMA Intern Med; ePub 2019 Mar 4; Schaefer, et al

Psychosocial Stress & CV Health in Older Women, Circulation; ePub 2019 Feb 28; Burroughs-Peña, et al

AHA Statement: CV Risk Reduction in Pediatrics, Circulation; ePub 2019 Feb 25; de Ferranti, et al

Sedentary Behaviors & CVD Risk in Older Women, Circulation; 2019 Feb 19; Bellettiere, et al