Affiliation:
1. Indiana University School of Medicine and Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, IN
Abstract
Background
Cardiovascular morbidity and mortality was reduced by 25% when blood pressure (
BP
) was targeted to 120 mm Hg systolic compared with 140 mm Hg systolic in Systolic Blood Pressure Intervention Trial (SPRINT); however,
BP
was measured using a research technique.
SPRINT
specified 5 minutes of seated rest in a quiet room followed by 3 oscillometric measurements without an observer in the room. The relationship of this research‐grade methodology to routine
BP
measurements is not known.
Methods and Results
Among 275 people with chronic kidney disease who had
BP
<140/90 mm Hg when they came to the clinic, we measured
BP
as in
SPRINT
and recorded
BP
on the same day without specification of seated rest. Compared with routine measurement, the research‐grade systolic
BP
was 12.7 mm Hg lower with wide limits of agreement (−46.1 to 20.7 mm Hg). Research grade systolic
BP
was 7.9 mm Hg lower than daytime ambulatory systolic
BP
and had wide agreement limits (−33.2 to 17.4 mm Hg). Whereas the routine, research‐grade, and daytime ambulatory systolic
BP
were all related to echocardiographic left ventricular hypertrophy, the strength of the relationship between research‐grade and daytime ambulatory systolic
BP
to left ventricular hypertrophy was similar and stronger than the strength of the relationship between routine systolic
BP
and left ventricular hypertrophy.
Conclusions
Taken together, these results suggest that translation of the
SPRINT
results will require measurement of
BP
as performed in that trial. Instead of an algebraic manipulation of routine clinic measurements, the
SPRINT
methodology of
BP
measurement would be needed at minimum if implementation of the
SPRINT
results were to be deployed in the population at large.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
113 articles.
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