Almost all older adults in SPRINT trial have predicted net benefit favoring systolic BP target <120 mm Hg versus <140 mm Hg
By Elana Gotkine HealthDay Reporter
FRIDAY, Feb. 21, 2025 (HealthDay News) — Most older adults in the Systolic Blood Pressure Intervention Trial (SPRINT) have a net benefit favoring a systolic blood pressure (BP) target <120 mm Hg, according to a study published online Feb. 18 in the Journal of the American Geriatrics Society.
Mitra S. Jamshidian, M.D., from the University of California San Francisco, and colleagues estimated the individualized net benefit of intensive BP lowering among community-dwelling older adults in SPRINT. Cox models were internally validated to predict an absolute difference in risk between treating to a systolic BP target <120 versus <140 mm Hg among 5,143 SPRINT participants aged 65 years and older. Net benefits of treatment were compared across categories of age, SPRINT-derived frailty status, and polypharmacy.
The researchers found that the median net benefit was 4 percentage points from intensive BP lowering when simulating preferences for participants who view the benefits of BP lowering as much more important than treatment-related harms, and 100 percent had a positive net benefit favoring intensive BP lowering. The median net benefit was 1 percentage point when simulating benefits and harms to have similar, intermediate importance, and 85 percent had a positive net benefit. Despite experiencing more harm in both simulations, participants with advanced age and frailty had greater net benefits from intensive BP lowering; when benefits were viewed as much more important than harms, those with polypharmacy had greater net benefits.
“The evidence from SPRINT can be translated to each person using individualized risks and preferences, and that consideration of advanced age, frailty, and polypharmacy alone should not deter clinicians from recommending intensive BP lowering,” the authors write.
Several authors disclosed ties to the pharmaceutical industry.
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