Elevated Blood Pressure Case Study

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SPRINT Elevated blood pressure (BP) is an important public health concern. It is highly prevalent and a risk factor for several adverse health outcomes, especially coronary heart disease, stroke, heart failure, chronic kidney disease, and decline in cognitive function. The Systolic Blood Pressure Intervention Trial (SPRINT) was designed to test whether a treatment program aimed at reducing systolic blood pressure (SBP) to a lower goal (120mmHg) than currently recommended (140mmHg) could reduce cardiovascular disease (CVD) risk. The SPRINT study enrolled more than 9 000 people from USA. It included patients aged over 50, with SBP from 130 to 180 mmHg and at least one associated item: additional CVD risk, clinical or subclinical CVD …show more content…
The Intensive arm had a goal of SBP <120 mm Hg. One or more medications from the following classes of agents were provided by the study: Angiotension converting enzyme (ACE)-inhibitors Angiotension receptor blockers (ARBs) Direct vasodilators Thiazide-type diuretics Loop diuretics Potassium-sparing diuretics Beta-blockers Sustained-release calcium channel blockers (CCBs) Alpha1-receptor blockers 2. The Standard arm had a goal of SBP <140 mm Hg. Therapy was intensified if SBP ≥160 mm Hg at 1 visit; ≥140 mm Hg at 2 consecutive visits; Down-titration was done if SBP <130 mm Hg at 1 visit; <135 mm Hg at 2 consecutive …show more content…
2.19% per year hazard ratio 0.75; 95% CI: 0.64 to 0.890) resulting from the reduction of Heart failure and Cardiovascular Death while (surprisingly) no reduction of Stroke was noted. All-cause mortality was also significantly lower in the intensive - treatment group (hazard ratio, 0.73; 95% CI, 0.60 to 0.90; P=0.003). The numbers needed to treat to prevent a primary outcome event, death from any cause, and death from cardiovascular causes during the median 3.26 years of the trial were 61, 90, and 172, respectively. These results were consistent across the pre-specified subgroups. There were no significant interactions between treatment and subgroups with respect to the primary outcome or death from any cause. A total of 220 participants in the intensive-treatment group (4.7%) and 118 in the standard- treatment group (2.5%) had serious adverse events (hypotension, syncope and acute kidney injury or failure) that were classified as related to the intervention (HR 1.88;
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