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Randomized Controlled Trial
. 2016 Feb 9;67(5):463-72.
doi: 10.1016/j.jacc.2015.10.037. Epub 2015 Nov 9.

Generalizability of SPRINT Results to the U.S. Adult Population

Adam P Bress  1 , Rikki M Tanner  2 , Rachel Hess  3 , Lisandro D Colantonio  2 , Daichi Shimbo  4 , Paul Muntner  5
Affiliations
Randomized Controlled Trial

Generalizability of SPRINT Results to the U.S. Adult Population

Adam P Bress et al. J Am Coll Cardiol. .

Abstract

Background: In SPRINT (Systolic Blood Pressure Intervention Trial), a systolic blood pressure (SBP) goal of <120 mm Hg resulted in lower cardiovascular disease (CVD) risk compared with an SBP goal of <140 mm Hg.

Objectives: The purpose of this study was to estimate the prevalence, number, and characteristics of U.S. adults meeting SPRINT eligibility criteria and determine the broader population to whom SPRINT could be generalized.

Methods: We conducted a cross-sectional, population-based study using data from the National Health and Nutrition Examination Survey, 2007 to 2012. The SPRINT inclusion criteria were age ≥50 years, SBP 130 to 180 mm Hg depending on the number of antihypertensive medication classes being taken, and high CVD risk (history of coronary heart disease, estimated glomerular filtration rate of 20 to 59 ml/min/1.73 m(2), 10-year CVD risk ≥15%, or age ≥75 years). Exclusion criteria were diabetes, history of stroke, >1 g in 24 h of proteinuria daily, heart failure, estimated glomerular filtration rate <20 ml/min/1.73 m(2), or receiving dialysis. Treated hypertension was defined by self-reported use of medication to lower blood pressure with ≥1 class of antihypertensive medication identified through a pill bottle review.

Results: Overall, 7.6% (95% confidence interval [CI]: 7.0% to 8.3%) or 16.8 million (95% CI: 15.7 to 17.8 million) U.S. adults, and 16.7% (95% CI: 15.2% to 18.3%) or 8.2 million (95% CI: 7.6 to 8.8 million) adults with treated hypertension met the SPRINT eligibility criteria. Among both the overall U.S. population and adults with treated hypertension, the percentage meeting SPRINT eligibility criteria increased with older age, was higher among males than females, and was higher among non-Hispanic whites compared with non-Hispanic blacks or Hispanics. Of U.S. adults eligible for SPRINT, 51.0% (95% CI: 47.8% to 54.1%) or 8.6 million (95% CI: 8.0 to 9.1 million) were not treated for hypertension.

Conclusions: A substantial percentage of U.S. adults meet the eligibility criteria for SPRINT.

Keywords: control; hypertension; population health; systolic blood pressure; treatment.

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Figures

FIGURE 1
FIGURE 1. Flowchart Showing the Eligibility Criteria for SPRINT Applied to NHANES, 2007 to 2012
CHD = coronary heart disease; CVD = cardiovascular disease; NHANES = National Health and Nutrition Examination Survey; SBP = systolic blood pressure; SPRINT = Systolic Blood Pressure Intervention Trial.
FIGURE 2
FIGURE 2. Number of U.S. Adults Meeting SPRINT Eligibility Criteria, Overall and Among Those With Treated Hypertension
See Online Table 2 for the numbers and 95% confidence intervals in the figure. Abbreviations as in Figure 1.
CENTRAL ILLUSTRATION
CENTRAL ILLUSTRATION. Number of U.S. Adults Meeting Each Sequential SPRINT Eligibility Criterion
The circles are proportional to the population sizes. CI = confidence interval; CVD = cardiovascular disease; SBP = systolic blood pressure; SPRINT = Systolic Blood Pressure Intervention Trial.
See this image and copyright information in PMC

Comment in

  • SPRINT: To Whom Do the Results Apply?
    Gradman AH. Gradman AH. J Am Coll Cardiol. 2016 Feb 9;67(5):473-5. doi: 10.1016/j.jacc.2015.12.006. J Am Coll Cardiol. 2016. PMID: 26846945 No abstract available.

References

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