Adults at high risk for cardiovascular disease who receive intensive systolic blood pressure control have significantly lower rates of death and cardiovascular disease events than those who receive standard control. However, the lifetime health benefits and health care costs associated with intensive control are not known.
Bress, with Supiano, Cheung, and colleagues, enhanced population health by defining what the Systolic Blood Pressure Intervention Trial (SPRINT) and the 2017 ACC/AHA blood pressure guidelines mean for clinical practice and public health. The authors found that 1) intensive blood pressure control is cost-effective, regardless of whether the benefits were reduced after five years or persisted for the patient’s remaining lifetime, and 2) if fully implemented in eligible U.S. adults, intensive blood pressure treatment could prevent >100,000 deaths per year.
Generalizability of SPRINT results to the U.S. adult population. Bress AP, Tanner RM, Hess R, Colantonio LD, Shimbo D, Muntner P. J Am Coll Cardiol. 2016 Feb 9;67(5):463.
Potential deaths averted and serious adverse events incurred from adoption of the SPRINT (systolic blood pressure intervention trial) intensive blood pressure regimen in the United States: projections from NHANES (national health and nutrition examination survey). Bress AP, Kramer H, Khatib R, Beddhu S, Cheung AK, Hess R, Bansal VK, Cao G, Yee J, Moran AE, Durazo-Arvizu R, Muntner P, Cooper RS. Circulation. 2017 Apr; ;135 (17):1617.
Cost-effectiveness of intensive versus standard blood-pressure control. Bress AP, Bellows BK, King JB, Hess R, Beddhu S, Zhang Z, Berlowitz DR, Conroy MB, Fine L, Oparil S, Morisky DE, Kazis LE, Ruiz-Negrón N, Powell J, Tamariz L, Whittle J, Wright JT Jr, Supiano MA, Cheung AK, Weintraub WS, Moran AE; SPRINT Research Group. N Engl J Med. 2017 Aug;377(8):745.
Potential cardiovascular disease events prevented with adoption of the 2017 American College of Cardiology/American Heart Association blood pressure guideline. Bress AP, Colantonio LD, Cooper RS, Kramer H, Booth JN 3rd, Odden MC, Bibbins-Domingo K, Shimbo D, Whelton PK, Levitan EB, Howard G, Bellows BK, Kleindorfer D, Safford MM, Muntner P, Moran AE. Circulation. 2019 Jan;139(1):24.