Format

Send to

Choose Destination
N Engl J Med. 2017 Aug 24;377(8):733-744. doi: 10.1056/NEJMoa1611179.

Effect of Intensive Blood-Pressure Treatment on Patient-Reported Outcomes.

Collaborators (734)

Whelton P, Johnson KC, Fine L, Bild D, Bonds D, Cook N, Cutler J, Kaufmann P, Launer L, Moy C, Riley W, Ryan L, Tolunay E, Yang S, Wright JT Jr, Rahman M, Lerner AJ, Still C, Wiggers A, Zamanian S, Bee A, Dancie R, Cushman W, Wall B, Nichols L, Burns R, Martindale-Adams J, Clark E, Walsh S, Geraci T, Huff C, Shaw L, Lewis CE, Bradley V, Calhoun D, Glasser S, Jenkins K, Cheung AK, Beddhu S, Chelune G, Childs J, Gren L, Randall A, Rocco M, Goff D, Rodriguez C, Coker L, Hawfield A, Yeboah J, Crago L, Summerson J, Hege A, Reboussin D, Williamson J, Ambrosius W, Applegate W, Evans G, Freedman BI, Kitzman D, Lyles M, Rapp S, Rushing S, Shah N, Sink KM, Vitolins M, Wagenknecht L, Wilson V, Perdue L, Woolard N, Craven T, Garcia K, Gaussoin S, Lovato L, Amoroso B, Davis P, Griffin J, Harris D, King M, Lane K, Roberson W, Steinberg D, Ashford D, Babcock P, Chamberlain D, Christensen V, Cloud L, Collins C, Cook D, Currie K, Felton D, Harpe S, Howard M, Lewis M, Nance P, Puccinelli-Ortega N, Russell L, Walker J, Craven B, Goode C, Troxler M, Davis J, Hutchens S, Killeen AA, Lukkari AM, Ringer R, Dillard B, Archibeque N, Warren S, Sather M, Pontzer J, Taylor Z, Soliman EZ, Zhang ZM, Li Y, Campbell C, Hensley S, Hu J, Keasler L, Barr M, Taylor T, Bryan RN, Davatzikos C, Nasarallah I, Desiderio L, Elliott M, Borthakur A, Battapady H, Erus G, Smith A, Wang Z, Doshi J, Townsend R, Cohen D, Huan Y, Duckworth M, Ford V, Sexton K, Lerner A, Stokes DL, Smith S, Sunshine J, Clampitt M, Smith S, Welch B, Donahue M, Dagley A, Pennell D, Cannistraci C, Merkle K, Lewis J, Sika M, Wright C, Sabati M, Campuzano E, Martin H, Roman A, Cruz J, Nagornaya N, Maldjian J, Kaminsky S, Fuller D, Jung Y, Lewis B, Wadley V, Evanochko W, Roberson G, Corbitt T, Fisher W, Clements C, Wells A, Civiletto A, Aurigemma GP, Bodkin N, Norbash A, Lavoye M, Ellison A, Killiany R, Sakai O, Cheung A, Sink K, Thomas G, Schreiber M Jr, Navaneethan SD, Hickner J, Lioudis M, Lard M, Marczewski S, Maraschky J, Colman M, Aaby A, Payne S, Ramos M, Horner C, Drawz P, Raghavendra PP, Ober S, Mourad R, Pallaki M, Russo P, Raghavendra P, Fantauzzo P, Tucker L, Schwing B, Sedor JR, Horwitz EJ, Schellling JR, O’Toole JF, Humbert L, Tutolo W, White S, Gay A, Clark W Jr, Hughes R, Dobre M, Still CH, Williams M, Bhatt U, Hebert L, Agarwal A, Murphy MB, Ford N, Stratton C, Baxter J, Lykins AA, Neal AM, Hirmath L, Kwame O, Soe K, Miser WF, Sagrilla C, Johnston J, Anaya A, Mintos A, Howell AA, Rogers K, Taylor S, Ebersbacher D, Long L, Bednarchik B, Schnall A, Smith J, Peysha L, Leach L, Tribout M, Harwell C, Ellington P, Banerji MA, Ghody P, Rambaud MV, Leshner J, Davison A, Vander Veen S, Gadegbeku CA, Gillespie A, Paranjape A, Amoroso S, Pfeffer Z, Quinn SB, He J, Chen J, Lustigova E, Malone E, Krousel-Wood M, Deichmann R, Ronney P, Muery S, Trapani D, Diamond M, Mulloy L, Hodges M, Collins M, Weathers C, Anderson H, Stone E, Walker W, McWilliams A, Dulin M, Kuhn L, Standridge S, Lowe L, Everett K, Preston K, Norton S, Gaines S, Rizvi AA, Sides AW, Herbert D, Hix MM, Whitmire M, Arnold B, Hutchinson P, Espiritu J, Feinglos M, Kovalik E, Gedon-Lipscomb G, Evans K, Thacker C, Zimmer R, Furst M, Mason M, Bolin P, Zhang J, Pinion M, Davis G, Bryant W, Phelps P, Garris-Sutton C, Atkinson B, Contreras G, Suarez M, Schulman I, Koggan D, Vassallo J, Peruyera G, Bethea C, Mayer S, Gilliam L, Pedley C, Zurek G, Baird M, Herring C, Smoak MM, Williams J, Rogers S, Gordon L, Kennedy E, Belle B, McCorkle-Doomy J, Adams J, Lopez R, Janavs J, Rahbari-Oskoui F, Chapman A, Dollar A, Williams O, Han Y, Haley W, Blackshear J, Shapiro B, Harrell A, Palaj A, Henderson K, Johnson A, Gonzalez H, Robinson J, Tamariz L, Denizard J, Barakat R, Krishnamoorthy D, Greenway F, Monce R, Church T, Hendrick C, Yoches A, Sones L, Baltazar M, Pemu P, Jones C, Akpalu D, Dember L, Soares D, Yee J, Umanath K, Ogletree N, Thaxton S, Campana K, Sheldon D, MacArthur K, Muhlestein JB, Allred N, Clements B, Dhar R, Meredith K, Le V, Miner E, Orford J, Riessen ER, Ballantyne B, Chisum B, Johnson K, Peeler D, Chertow G, Tamura M, Chang T, Erickson K, Shen J, Stafford RS, Zaharchuk G, Del Cid M, Dentinger M, Sabino J, Sahay R, Telminova E, Sarnak M, Chan L, Heath A, Kantor A, Jain P, Kirkpatrick B, Well A, Yuen B, Chonchol M, Farmer B, Farmer H, Greenwald C, Malaczewski M, Lash J, Porter A, Ricardo A, Rosman RT, Cohan J, Lopez Barrera N, Meslar D, Meslar P, Conroy M, Unruh M, Hess R, Jhamb M, Thomas H, Fazio P, Klixbull E, Komlos-Weimer M, Mandich L, Vita T, Toto R, Van Buren P, Inrig J, Cruz M, Lightfoot T, Wang N, Webster L, Raphael K, Stults B, Zaman T, Lavasani T, Filipowicz R, Wei G, Miller GM, Harerra J, Christensen J, Giri A, Chen X, Anderton N, Jensen A, Lewis J, Burgner A, Dwyer JP, Schulman G, Herrud T, Leavell E, McCray T, McNeil-Simaan E, Poudel M, Reed M, Woods D, Zirkenbach JL, Raj DS, Cohen S, Patel S, Velasquez M, Bastian RS, Wing M, Roy-Chaudhury A, Depner T, Dalyrymple L, Kaysen G, Anderson S, Nord J, Ix JH, Goldenstein L, Miracle CM, Forbang N, Mircic M, Thomas B, Tran T, Rastogi A, Kim M, Rashid M, Lizarraga B, Hocza A, Sarmosyan K, Norris J, Sharma T, Chioy A, Bernard E, Cabrera E, Lopez C, Nunez S, Riad J, Schweitzer S, Sirop S, Thomas S, Wada L, Kramer H, Bansal V, Taylor CE, Segal MS, Hall KL, Kazory A, Gilbert L, Owens L, Poulton D, Whidden E, Wiggins J, Blaum C, Nyquist L, Min L, Lewis R, Mawby J, Robinson E, Qureshi N, Ferguson K, Haider S, James M, Jones C, Renfroe K, Seay A, Weigart C, Thornley-Brown D, Rizik D, Cotton B, Fitz-Gerald M, Grimes T, Johnson C, Kennedy S, Mason C, Rosato-Burson L, Willingham R, Judd E, Breaux-Shropshire T, Cook F, Medina J, Lewis J, Brantley R, Brouilette J, Glaze J, Hall S, Hiott N, Tharpe D, Boddy S, Mack C, Womack C, Griffin B, Hendrix C, Johnson K, Jones L, Towers C, Punzi H, Cassidy K, Schumacher K, Irizarry C, Colon I, Colon-Ortiz P, Colon-Hernandez P, Carrasquillo M, Vazquez N, Sosa-Padilla M, Cintron-Pinero A, Ayala M, Pacheco O, Rivera C, Sotomayor-Gonzalez I, Claudio J, Lazaro J, Arce M, Heres L, Perez A, Tavarez-Valle J, Arocho F, Torres M, Vazquez M, Takis-Smith R, Andrieni J, Chaudhary K, Hu P, Kostis J, Kostis WJ, Cosgrove N, Bankowski D, Boleyn M, Casazza L, Giresi V, Patel T, Squindo E, Wu Y, Wofford M, Flessner M, Adair C, Asher J, Loope D, Cobb R, Venegas R, Bigger T, Donovan D, Lopez-Jimenez C, Tirado A, Getaneh A, Tang R, Durant S, Maurer M, Teruya S, Helmke S, Alvarez J, Campbell R, Pisoni R, Sturdivant R, Counts C, Hunt V, Spillers L, Brautigam D, Kitchen T, Gorman T, Sayers J, Button S, Chiarot J, Fischer R, Lyon M, Resnick M, Servilla K, Vigil D, Barrett T, Sweeney ME, Johnson R, McConnell S, Salles KS, Watson F, Schenk C, Whittington L, Maher M, Williams J, Swartz S, Conlin P, Alexis G, Lamkin R, Underwood P, Gomes H, Peters JJ, Rosendorff C, Atlas S, Kwon L, Matar M, Johnson RH, Basile J, John J, Ham D, Baig H, Saklayen M, Yap J, Neff H, Miller C, Zheng-Phelan L, Dingell JD, Gappy S, Rau S, Raman A, Berchou V, Jones E, Olgren E, Yudd M, Sastrasinh S, Michaud J, Fiore J, Kutza M, Randall M, Shorr R, Mount R, Thoms J, Dunn H, Stinson S, Hunter J, DeBakey ME, Taylor A, Bates J, Anderson C, Montgomery GV, Stubbs J, Hinton A, Spencer A, City K, Sharma S, Wiegmann T, Mehta S, Krause M, Dishongh K, Childress R, Gyamlani G, Niakan A, Thompson C, Moody J, Zablocki CJ, Barnas G, Wolfgram D, Cortese H, Johnson J, Roumie C, Hung A, Wharton J, Niesner K, Katz L, Richardson E, Brock G, Holland J, Dixon T, Zias A, Spiller C, Baker P, Felicetta J, Rehman S, Bingham K, Watnick S, Weiss J, Johnston T, Giddings S, Klein A, Rowe C, Vargo K, Waidmann K, Papademetriou V, Elkhoury JP, Gregory B, Amodeo S, Bloom M, Goldfarb-Waysman D, Treger R, Knibloe K, Ishani A, Slinin Y, Rust J, Fanti P, Bansal S, Dunnam M, Dyer C, Hu LL, Zarate-Abbott P.

Abstract

BACKGROUND:

The previously published results of the Systolic Blood Pressure Intervention Trial showed that among participants with hypertension and an increased cardiovascular risk, but without diabetes, the rates of cardiovascular events were lower among those who were assigned to a target systolic blood pressure of less than 120 mm Hg (intensive treatment) than among those who were assigned to a target of less than 140 mm Hg (standard treatment). Whether such intensive treatment affected patient-reported outcomes was uncertain; those results from the trial are reported here.

METHODS:

We randomly assigned 9361 participants with hypertension to a systolic blood-pressure target of less than 120 mm Hg or a target of less than 140 mm Hg. Patient-reported outcome measures included the scores on the Physical Component Summary (PCS) and Mental Component Summary (MCS) of the Veterans RAND 12-Item Health Survey, the Patient Health Questionnaire 9-item depression scale (PHQ-9), patient-reported satisfaction with their blood-pressure care and blood-pressure medications, and adherence to blood-pressure medications. We compared the scores in the intensive-treatment group with those in the standard-treatment group among all participants and among participants stratified according to physical and cognitive function.

RESULTS:

Participants who received intensive treatment received an average of one additional antihypertensive medication, and the systolic blood pressure was 14.8 mm Hg (95% confidence interval, 14.3 to 15.4) lower in the group that received intensive treatment than in the group that received standard treatment. Mean PCS, MCS, and PHQ-9 scores were relatively stable over a median of 3 years of follow-up, with no significant differences between the two treatment groups. No significant differences between the treatment groups were noted when participants were stratified according to baseline measures of physical or cognitive function. Satisfaction with blood-pressure care was high in both treatment groups, and we found no significant difference in adherence to blood-pressure medications.

CONCLUSIONS:

Patient-reported outcomes among participants who received intensive treatment, which targeted a systolic blood pressure of less than 120 mm Hg, were similar to those among participants who received standard treatment, including among participants with decreased physical or cognitive function. (Funded by the National Institutes of Health; SPRINT ClinicalTrials.gov number, NCT01206062 .).

PMID:
28834483
PMCID:
PMC5706112
DOI:
10.1056/NEJMoa1611179
[Indexed for MEDLINE]
Free PMC Article

Publication types, MeSH terms, Substance, Secondary source ID, Grant support

Publication types

MeSH terms

Substance

Secondary source ID

Grant support

Supplemental Content

Full text links

Icon for Atypon Icon for PubMed Central
Loading ...
Support Center