Intensive BP Control May Increase Residual Lifespan in Patients at High Risk for CVD

PHILADELPHIA — Tight, intensive blood pressure (BP) control was found to improve residual survival length in middle aged and older individuals at risk for cardiovascular disease, according to results from the Systolic Blood Pressure Intervention Trial (SPRINT) presented at the 2019 American Heart Association Scientific Sessions, held November 16-18, 2019, in Philadelphia, Pennsylvania.¹

According to researchers, the early termination of the SPRINT trial (Clinicaltrials.gov identifier: NCT01206062) after a median follow-up of 3 years did not allow to assess the effects on life expectancy of BP control strategies. The investigators used baseline age to estimate residual survival (up to 95 years; using the area under the curve). A total of 9361 adults (≥50 years; mean age, 68±9 years) at high risk for cardiovascular disease and without diabetes were enrolled in the SPRINT trial. Participants had a screening systolic BP between 130 and 180 mmHg.

The mean survival benefits — estimated using differences in areas under the curve — associated with the use of intensive vs standard BP control ranged from 0.5 to 3 years. At age 50 years, estimated residual survival was 37.3 and 34.4 years with intensive and standard treatments, respectively (difference, 2.9 years; 95% CI, 0.9-5.0 years; P =.008). At 65 years, residual survival was 24.5 and 23.3 years with intensive and standard BP control treatments, respectively (difference 1.1; 95% CI, 0.1-2.1 years; P =.029), and at age 80, residual survival was 11.9 and 11.1 years, with intensive and standard BP control treatments, respectively  (difference, 0.8 years; 95% CI, 0.01-1.6 years; P =.044).

Although absolute survival gains with intensive vs standard BP control were found to decrease with age, benefits ranged from 4% to 9%. Middle-age, at-risk patients were found to benefit the most from intensive BP control treatment.

“High [BP] has been implicated as one of the reasons for stalled progress in reducing heart disease-related deaths in the United States,” said Muthiah Vaduganathan, MD, MPH, lead study author and associate professor of medicine at Brigham and Women’s Hospital in Boston, Massachusetts.² “These data reinforce that tighter [BP] control, especially when started earlier in life, may meaningfully prolong life span.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

References

1. Vaduganathan M, Claggett B, Juraschek SP, Solomon SD. Effect of intensive blood pressure control on residual lifespan in the SPRINT Trial. Presented at: American Heart Association Scientific Sessions; November 16-18, 2019; Philadelphia, PA. Abstract MDP233.
2. Studies explore potential benefits and costs of increased treatment to achieve lower blood pressure targets [news release]. Dallas, TX: American Heart Association; November 11, 2019. https://newsroom.heart.org/news/studies-explore-potential-benefits-and-costs-of-increased-treatment-to-achieve-lower-blood-pressure-targets. Accessed November 13, 2019.