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Determination of optimal on-treatment diastolic blood pressure range using automated measurements in subjects with cardiovascular disease-Analysis of a SPRINT trial subpopulation.
Determination of optimal on-treatment diastolic blood pressure range using automated measurements in subjects with cardiovascular disease-Analysis of a SPRINT trial subpopulation.
- Source :
-
Journal of clinical hypertension (Greenwich, Conn.) [J Clin Hypertens (Greenwich)] 2019 Jul; Vol. 21 (7), pp. 911-918. Date of Electronic Publication: 2019 Jun 06. - Publication Year :
- 2019
-
Abstract
- Automated office blood pressure measurement (AOBPM) is recommended for diagnosing hypertension; however, optimal treatment targets using this method are not established. Discrepancies between automated and office measurements of blood pressure have been described, producing uncertainty regarding the use of AOBPM in clinical practice. The Systolic Blood Pressure Intervention Trial (SPRINT) results improved our understanding of target AOBPM systolic blood pressure (SBP) levels; however, diastolic blood pressure (DBP) targets remain unknown. Therefore, we sought to determine the optimal on-treatment DBP range. The analysis was performed on the participants of the SPRINT trial who had hypertension and prior cardiovascular disease. We analyzed the data of 1470 participants (mean age 70.3 ± 9.3 years, 24.1% female) selected from the SPRINT trial database of National Heart, Lung and Blood Institute. The mean achieved SBP and DBP were 127.9 ± 10.7 and 68.3 ± 9.4 mm Hg, respectively. Most of the participants (57.4%) had a DBP lower than 70 mm Hg, while only 11.7% had DPB ≥80 mm Hg. Clinical composite endpoint was defined as myocardial infarction, acute coronary syndrome not resulting in myocardial infarction, stroke, acute decompensated heart failure or death from cardiovascular causes. There were 159 (10.8%) clinical endpoint events. The participants with on-treatment AOBPM DBP range of 68.6-78.6 mm Hg showed the lowest hazard risk of a clinical composite endpoint. These results correspond to the office DBP range of 70-80 mm Hg recommended in ESC guidelines. This is the first attempt to determine the range of optimal DBP values using population-based AOBPM in patients with prior cardiovascular disease.<br /> (©2019 Wiley Periodicals, Inc.)
- Subjects :
- Aged
Ankle Brachial Index methods
Antihypertensive Agents therapeutic use
Female
Humans
Male
Outcome and Process Assessment, Health Care
Patient Care Planning standards
Poland epidemiology
Risk Assessment
Risk Factors
Blood Pressure
Blood Pressure Monitoring, Ambulatory methods
Blood Pressure Monitoring, Ambulatory statistics & numerical data
Coronary Disease diagnosis
Coronary Disease epidemiology
Hypertension diagnosis
Hypertension drug therapy
Hypertension epidemiology
Hypertension physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1751-7176
- Volume :
- 21
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of clinical hypertension (Greenwich, Conn.)
- Publication Type :
- Academic Journal
- Accession number :
- 31169350
- Full Text :
- https://doi.org/10.1111/jch.13581