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November 18, 2015
At Least 16 Million Americans Eligible for Intensive BP Control
Salt Lake City, UT—The initial analysis of the Systolic Blood Pressure Intervention Trial (SPRINT) was made public in September and showed that using antihypertensive medications to reach a lower systolic blood pressure target of 120 mmHg, as opposed to current guidelines of 140 or 150 mmHg, could greatly reduce risk for heart failure, heart attack, and death.
But how many Americans would that actually affect?
A new study in the Journal of the American College of Cardiology reports that at least 16.8 million Americans could potentially benefit from new guidelines based on SPRINT. A collaborative investigation involving researchers from the University of Utah, the University of Alabama at Birmingham, and Columbia University calculated the potential impact of preliminary results from SPRINT, which was presented in full at the American Heart Association meeting and published online in the New England Journal of Medicine.
“SPRINT could have broad implications,” lead author Adam Bress, PharmD, MS, an assistant professor of pharmacotherapy at the University of Utah College of Pharmacy, explained in a press release. “Millions of Americans whose blood pressure is under control according to current guidelines may be considered uncontrolled if new guidelines adopt the intensive target of less than 120 mmHg studied in SPRINT.”
While study authors note that new medical guidelines for treating hypertension could be months to years away, their research finds that more than 16.8 million Americans, 7.6%, could be recommended for intensive blood pressure management if guidelines incorporate a new, lower, systolic blood pressure (SBP) target based on SPRINT results.
In effect, those are Americans who are age 50 or older, have an SBP between 130-180 mmHg, are at high risk for cardiovascular disease, and do not have diabetes or a history of stroke, among other inclusion and exclusion criteria.
Some segments of the population might be more affected than others, according to the report. For example, compared to Caucasians, African Americans, and Hispanics were less likely to meet SPRINT eligibility criteria—9% percent versus 4.8% and 4.3%, respectively—because minority populations tend to have a higher prevalence of diabetes and other health conditions that could preclude them from being SPRINT eligible, according to the study.
Men are also more likely to be eligible for SPRINT than women—8.8% vs. 6.5%—because cardiovascular disease risk tends not to increase for women until they are older than 65, study authors point out.
Based on analyzing data from the 16,260 participants in the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2012 who met certain SPRINT inclusion and exclusion criteria, the following numbers would meet SPRINT eligibility requirements:
• 219 million adults
• 95.1 million age 50 or older
• 37.3 million with elevated blood pressure (greater than 130 mmHg)
• 26.4 million at high risk for cardiovascular disease
• 16.8 million with no diabetes, history of stroke, or other SPRINT exclusion criteria
“Given that millions of U.S. adults meet SPRINT eligibility criteria, the implementation of SPRINT recommendations could have a profound impact on how blood pressure is treated in this country,” said senior author Paul Muntner, PhD, a professor of epidemiology at the University of Alabama. “Even more important, is its potential for greatly reducing the incidence of cardiovascular disease.”
 
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