Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The VSports app下载. gov means it’s official. Federal government websites often end in . gov or . mil. Before sharing sensitive information, make sure you’re on a federal government site. .

Https

The site is secure V体育官网. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. .

Randomized Controlled Trial
. 2017 Aug 24;377(8):733-744.
doi: 10.1056/NEJMoa1611179.

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

Dan R Berlowitz  1 , Capri G Foy  1 , Lewis E Kazis  1 , Linda P Bolin  1 , Molly B Conroy  1 , Peter Fitzpatrick  1 , Tanya R Gure  1 , Paul L Kimmel  1 , Kent Kirchner  1 , Donald E Morisky  1 , Jill Newman  1 , Christine Olney  1 , Suzanne Oparil  1 , Nicholas M Pajewski  1 , James Powell  1 , Thomas Ramsey  1 , Debra L Simmons  1 , Joni Snyder  1 , Mark A Supiano  1 , Daniel E Weiner  1 , Jeff Whittle  1 ; SPRINT Research Group
Collaborators, Affiliations
Randomized Controlled Trial

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

Dan R Berlowitz et al. N Engl J Med. .

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. VSports手机版.

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 V体育安卓版. .

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 V体育ios版. 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 . ) VSports最新版本. .

PubMed Disclaimer

Figures (V体育安卓版)

Figure 1
Figure 1. Patient-Reported Outcomes in the Two Treatment Groups over Time
The data points represent the estimated mean based on a linear mixed model; I bars denote 95% confidence intervals. The values below each graph indicate the number of participants assessed at each trial visit. Scores on the Physical Component Summary (PCS) and Mental Component Summary (MCS) of the Veterans RAND 12-Item Health Survey (VR-12) are standardized with a mean of 50 and a standard deviation of 10; scores range from 0 to 100, with higher scores denoting better physical health and mental health, respectively. Scores on the Patient Health Questionnaire 9-item depression scale (PHQ-9) range from 0 to 27, with higher scores indicating greater severity of depressive symptoms and scores of 10 or higher suggesting moderate-to-severe depressive symptoms.
Figure 2
Figure 2. Scores on the VR-12 over Time, According to Treatment Group and Number of Medical Coexisting Conditions
The burden of medical coexisting conditions was categorized as 2 or fewer, 3 or 4, 5 or 6, or 7 or more. The data points represent the estimated mean based on a linear mixed model, with I bars denoting 95% confidence intervals. The values below each graph indicate the number of participants assessed at each trial visit, according to the number of coexisting conditions participants had at baseline. Coexisting conditions were reported by the participants with the use of the Selim comorbidity index, which assesses 30 medical conditions and 6 mental health conditions. The physical score on the Selim comorbidity index was calculated as the sum of the number of these 30 possible medical conditions reported, and the mental score was the sum of the number of these 6 possible mental health conditions reported.
Figure 3
Figure 3. Scores on the VR-12 over Time, According to Treatment Group and Age Category
The data points represent the estimated mean based on a linear mixed model, with I bars denoting 95% confidence intervals. The values below each graph indicate the number of participants assessed at each trial visit, according to age category.
See this image and copyright information in PMC

Comment in

References

    1. The SPRINT Research Group. A randomized trial of intensive versus standard blood pressure control. N Engl J Med. 2015;373:2103–16. - V体育平台登录 - PMC - PubMed
    1. Ortiz E, James PA. Let’s not SPRINT to judgment about new blood pressure goals. Ann Intern Med. 2016;165:889–90. - PubMed
    1. Saper CB. How low can you go? Ann Neurol. 2015;78:665–6. - "VSports手机版" PubMed
    1. Schiffrin EL, Calhoun DA, Flack JM. SPRINT proves that lower is better for nondiabetic high-risk patients, but at a price. Am J Hypertens. 2016;29:2–4. - PubMed (VSports app下载)
    1. Moonen JEF, Foster-Dingley JC, de Ruijter W, et al. Effect of discontinuation of antihypertensive treatment in elderly people on cognitive functioning — the DANTE Study Leiden. JAMA Intern Med. 2015;175:1622–30. - PubMed

Publication types

MeSH terms

Substances (VSports在线直播)

VSports注册入口 - Associated data