scholarly journals Visit‐to‐visit office blood pressure variability combined with Framingham risk score to predict all‐cause mortality: A post hoc analysis of the systolic blood pressure intervention trial

2021 ◽  
Author(s):  
Yi Cheng ◽  
Jian Li ◽  
Xinping Ren ◽  
Dan Wang ◽  
Yulin Yang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Risk Score ◽  
Blood Pressure Variability ◽  
Framingham Risk Score ◽  
Intervention Trial ◽  
Post Hoc Analysis ◽  
Framingham Risk ◽  
All Cause Mortality ◽  
Post Hoc

scholarly journals Accurate estimation of cardiovascular risk in a non-diabetic adult: detecting and correcting the error in the reported Framingham Risk Score for the Systolic Blood Pressure Intervention Trial population

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e021685 ◽  
Author(s):  
Frederick Warner ◽  
Sanket S Dhruva ◽  
Joseph S Ross ◽  
Pranammya Dey ◽  
Karthik Murugiah ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Intervention Trial ◽  
Framingham Risk ◽  
Study Population ◽  
Study Participants

ObjectivesTo understand the discrepancy between the published 10-year cardiovascular risk and 10-year cardiovascular risk generated from raw data using the Framingham Risk Score for participants in the Systolic Blood Pressure Intervention Trial (SPRINT).DesignSecondary analysis of SPRINT data published inThe New England Journal of Medicine(NEJM) and made available to researchers in late 2016.SettingSPRINT clinical trial sites.ParticipantsStudy participants enrolled into SPRINT.ResultsThe number of SPRINT study participants identified as having ≥15% 10-year cardiovascular risk was not consistent with what was reported in the original publication. Using the data from the trial, the Framingham Risk Score indicated ≥15% 10-year cardiovascular risk for 7089 participants compared with 5737 reported in the paper, a change from 61% to 76% of the total study population.ConclusionsThe analysis of the clinical trial data by independent investigators identified an error in the reporting of the risk of the study population. The SPRINT trial enrolled a higher risk population than was reported in the initial publication, which was brought to light by data sharing.

scholarly journals Increased risk of Roma for 10-year development of CVDs based on Framingham Risk Score calculation

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
P Piko ◽  
S Fiatal ◽  
Z Kosa ◽  
J Sandor ◽  
R Adany
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
General Population ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Roma Population ◽  
Framingham Risk

Abstract Background Increased mortality and short life expectancy of Roma are well known epidemiological findings which can be partially explained by the high prevalence of cardiovascular risk factors among them. This study assesses the prevalence of the cardiovascular disease (CVD) risk factors (age, sex, systolic blood pressure, smoking and diabetes status, elevated total and reduced high density lipoprotein cholesterol level (HDL-C)) and the estimation of 10-year risk of development of CVD (CVD in general, coronary heart disease (CHD), myocardial infarction (MI) and stroke) and that of death from CHD and CVD based on the Framingham Risk Score (FRS) in case of the Hungarian general (HG) and Roma (HR) populations. Methods A complex health survey incl. questionnaire based interview, physical examination and laboratory test was carried out in 2018 on the HG and HR populations. The prevalence of different cardiovascular risk factors was defined and FRS was computed and compared between the HG (n = 378) and HR (n = 386) populations. Results The prevalence of diabetes was significantly higher among Roma females compared to females of general population (17.8% vs. 7.7%; p = 0.001) while the average systolic blood pressure level was less elevated among Roma males (127.9 mmHg vs. 129.4 mmHg; p = 0.020). The prevalence of smoking (males: 63.1% vs. 33.7%; females: 67.6% vs. 31%; p < 0.001) and reduced HDL-C level (males: 40% vs. 25.9%, p = 0.014; females: 55.5% vs. 35.1%, p < 0.001) were significantly higher in both sexes among Roma. The 10-year estimated risk for development of CHD, MI and CVD and the death from CHD was significantly (P < 0.05) higher in both sexes among Roma compared to the general population while the average risk scores for stroke and death from CVD were significantly higher only among Roma men. Conclusions Our results show that both sexes in the Roma population have a significantly higher risk for 10-year development of CVD compared to the Hungarian general population. Key messages The Roma population have a significantly higher risk for 10-year development of cardiovascular diseases and death from them based on the Framingham Risk Score. The targeted cardiovascular interventions should be focus on reduce smoking and provide information on the recognition and treatment of diabetes and lipid disorders among Roma.

scholarly journals Increased Blood Pressure Variability and the Risk of Probable Dementia or Mild Cognitive Impairment: A Post Hoc Analysis of the SPRINT MIND Trial

2021 ◽  
Author(s):  
Adam de Havenon ◽  
Mohammad Anadani ◽  
Shyam Prabhakaran ◽  
Ka‐Ho Wong ◽  
Shadi Yaghi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Systolic Blood Pressure ◽  
Blood Pressure Variability ◽  
Pressure Control ◽  
Post Hoc Analysis ◽  
The Mean ◽  
Post Hoc

Background Increased systolic blood pressure variability (BPV) is associated with stroke, cardiovascular disease, and dementia and mild cognitive impairment. However, prior studies assessing the relationship between BPV and dementia or mild cognitive impairment had infrequent measurement of blood pressure or suboptimal blood pressure control. Methods and Results We performed a post hoc analysis of the SPRINT (Systolic Blood Pressure Intervention Trial) MIND (Memory and Cognition in Decreased Hypertension) trial. The primary outcome was probable dementia during follow‐up. We defined our exposure period, during which blood pressures were collected, as the first 600 days of the trial, and outcomes were ascertained during the subsequent follow‐up. BPV was measured as tertiles of systolic blood pressure standard deviation. We fit Cox proportional hazards models to our outcome. We included 8379 patients. The mean follow‐up was 3.2±1.4 years, during which 316 (3.8%) patients developed dementia. The mean number of blood pressure measurements was 7.8, and in the tertiles of BPV, the SD was 6.3±1.6, 10.3±1.1, and 16.3±3.6 mm Hg, respectively. The rate of dementia was 2.4%, 3.6%, and 5.4% by ascending tertile, respectively ( P <0.001). In the Cox models, compared with the lowest tertile of BPV, the highest tertile of BPV increased the risk of dementia in both unadjusted (hazard ratio [HR], 2.36; 95% CI, 1.77–3.15) and adjusted (HR, 1.69; 95% CI, 1.25–2.28) models. Conclusions In a post hoc analysis of the SPRINT MIND trial, we found that higher BPV was associated with the development of probable dementia despite excellent blood pressure control. Additional research is needed to understand how to reduce BPV and if its reduction lowers the risk of cognitive impairment and dementia.

Long term habitual vigorous physical activity is associated with lower visit-to-visit systolic blood pressure variability

2020 ◽  
Author(s):  
Xiaoyong Xu ◽  
Xianghong Meng ◽  
Shin-ichi Oka
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Standard Deviation ◽  
Systolic Blood Pressure ◽  
Blood Pressure Variability ◽  
Vigorous Physical Activity ◽  
Systolic Blood Pressure Variability ◽  
Average Real Variability ◽  
Post Hoc

Abstract Objective Our work aimed to investigate the association between vigorous physical activity and visit-to-visit systolic blood pressure variability (BPV). Methods We conducted a post hoc analysis of SPRINT (Systolic Blood Pressure Intervention Trial), a well-characterized cohort of participants randomized to intensive (&lt;120 mmHg) or standard (&lt;140 mmHg) SBP targets. We assessed whether patients with hypertension who habitually engage in vigorous physical activity would have lower visit-to-visit systolic BPV compared with those who do not engage in vigorous physical activity. Visit-to-visit systolic BPV was calculated by standard deviation (SD), average real variability (ARV), and standard deviation independent of the mean (SDIM) using measurements taken during the 1-, 2-, 3-, 6-, 9- and 12-month study visits. A medical history questionnaire assessed vigorous physical activity, which was divided into three categories according to the frequency of vigorous physical activity. Results A total of 7571 participants were eligible for analysis (34.8% female, mean age 67.9±9.3 years). During a follow-up of 1-year, vigorous physical activity could significantly reduce SD, ARV, and SDIM across increasing frequency of vigorous physical activity. There were negative linear trends between frequency of vigorous physical activity and visit-to-visit systolic BPV. Conclusions Long-term engagement in vigorous physical activity was associated with lower visit-to-visit systolic BPV.

Modifying Effect of Statins on Fatal Outcomes in Chronic Kidney Disease Patients in the Systolic Blood Pressure Intervention Trial: A Post Hoc Analysis

2019 ◽  
Vol 49 (4) ◽  
pp. 297-306 ◽  
Author(s):  
Manuel Rivera ◽  
Leonardo Tamariz ◽  
Maritza Suarez ◽  
Gabriel Contreras
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Systolic Blood Pressure ◽  
Statin Therapy ◽  
Statin Group ◽  
All Cause Mortality ◽  
Modifying Effect ◽  
Post Hoc ◽  
Event Rates

Background: Management of chronic kidney disease (CKD) patients includes efforts directed toward modifying traditional cardiovascular risk factors. Such efforts include optimal management of hypertension together with the initiation of statin therapy. Methods: In this observational study, we determine the modifying effect of statins on the relationship of systolic blood pressure (SBP) goal with mortality and other outcomes in patients with CKD participating in a clinical trial. At baseline, 2,646 CKD patients (estimated glomerular filtration rate < 60 mL/min/1.73 m2) were randomized to an intensive SBP goal < 120 mm Hg or standard SBP goal <140 mm Hg. One thousand two hundred and seventy-three were not on statin, 1,354 were on a statin, and in 19 the use of statin was unknown. The 2 primary outcomes were all-cause mortality and cardiovascular disease (CVD) mortality. Results: The relationships of SBP goal with all-cause mortality (interaction p = 0.009) and cardiovascular (CV) mortality (interaction p = 0.021) were modified by the use of statin after adjusting for age, gender, race, CVD history, smoking, aspirin use, and blood pressure at baseline. In the statin group, targeting SBP to < 120 mm Hg compared to SBP < 140 mm Hg significantly reduced the risk of all-cause mortality (adjusted hazard ratio [aHR] 0.44 [0.28–0.71]; event rates 1.16 vs. 2.5 per 100 patient-years) and CV mortality (aHR 0.29 [0.12–0.74]; event rates 0.28 vs. 0.92 per 100 patient-years) after a median follow-up of 3.26 years. In the non-statin group, the risk of all-cause mortality (aHR 1.07 [0.69–1.66]; event rates 2.01 vs. 1.94 per 100 patient-years) and CV mortality (aHR 1.42 [0.56–3.59]; event rates 0.52 vs. 0.41 per 100 patient-years) were not significantly different in both SBP goal arms. Conclusion: The combination of statin therapy and intensive SBP management leads to improved survival in hypertensive patients with CKD.

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