Tighter blood pressure control may save over 100,000 US lives each year

Al Saint Jacques, MDLinx | November 30, 2016

Intensive systolic blood pressure (SBP) lowering may prevent more than 100,000 deaths in the United States each year, according to a study that was presented at American Society of Nephrology’s Kidney Week 2016 conference held November 15-20 at McCormick Place in Chicago, IL.

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Researchers found that intensive SBP lowering prolonged life compared with standard SBP lowering in adults over age 50 years who were at high risk for cardiovascular disease but who did not have diabetes or a history of stroke.

Researchers working on the Systolic Blood Pressure Intervention Trial (SPRINT) found that intensive SBP lowering (≤120 mm Hg) prolonged life compared with standard SBP lowering (≤140 mm Hg) in adults over age 50 years who were at high risk for cardiovascular disease but who did not have diabetes or a history of stroke.

In SPRINT, Tisha Joerla Tan, MD, of Loyola University Medical Center in Maywood, IL, and her colleagues randomized 9,361 adults over 50 years of age at high cardiovascular disease (CVD) risk without diabetes or stroke to either intensive systolic blood pressure (SBP) lowering (≤120 mmHg) or standard SBP lowering (≤140 mmHg). After a median follow up of 3.26 years, all-cause mortality was 27% (95% CI 40%, 10%) lower with intensive SBP lowering. They estimated the potential number of prevented deaths with intensive SBP lowering in the US population meeting SPRINT criteria.

They estimated that approximately 18.1 million US adults met SPRINT criteria with 7.4 million taking blood pressure lowering medication. They applied SPRINT eligibility criteria to the National Health and Nutrition Examination Survey 1999-2006, a representative survey of the US population, linked with the mortality data through December 2011.

The mean age of subjects in the study was 68.6 years and 83.2% and 7.4% were non-Hispanic white and non-Hispanic black, respectively. The annual mortality rate was 2.2% (95% CI 1.9%, 2.5%) and intensive SBP lowering was projected to prevent 107,453 deaths per year (95% CI 45,374, 139,490). Among the estimated 4.1 million adults with eGFR 20 to 59 ml/min/1.73 m2 meeting SPRINT criteria, the annual mortality rate was 2.9% (95% CI 2.3%, 3.6%) and intensive SBP lowering was projected to prevent 32,145 deaths per year (95% CI 25,493 ? 39,903) in this group.

“Our analyses also showed that more than 4 million adults with stage 3 to 4 chronic kidney disease meet SPRINT criteria, and intensive SBP lowering was projected to prevent 32,800 deaths per year in this group,” explained Dr. Tan.

The group concluded that intensive SBP lowering could prevent over 100,000 deaths per year.

Other researchers involved in the study included Richard Cooper and Holly J. Kramer of Loyola University Medical Center, Paul Muntner of the University of Alabama, and Adam Bress and Srini Beddhu of the University of Utah.

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