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Canadian Journal of Cardiology

Applicability of the Systolic Blood Pressure Intervention Trial (SPRINT) to the Canadian Population

      Abstract

      Background

      The Systolic Blood Pressure Intervention Trial (SPRINT) showed significant reductions in major cardiovascular events and all-cause mortality with a systolic blood pressure (BP) goal of < 120 mm Hg compared with < 140 mm Hg. We sought to determine the proportion of Canadian adults who meet SPRINT eligibility criteria.

      Methods

      We conducted a cross-sectional study using cycles 1-3 of the nationally representative Canadian Health Measures Survey to estimate the prevalence and characteristics of Canadian adults between the ages of 20 and 79 who meet SPRINT eligibility criteria: age ≥ 50 years, elevated systolic BP of 130-180 mm Hg, and increased cardiovascular risk (with chronic kidney disease, Framingham Risk Score ≥ 15% in 10 years, and/or cardiovascular disease) but without diabetes, stroke, or end-stage renal disease.

      Results

      An estimated 1.3 million (5.2%) Canadian adults met SPRINT eligibility criteria; 14.3% (95% confidence interval, 10.6%-17.9%), or 182,600 people, were not previously considered to have hypertension or need for antihypertensive therapy. Of adults aged 50-79 years treated for hypertension, 18.7% (95% confidence interval, 15.5%-21.8%), or 754,400 individuals, would potentially benefit from treatment intensification.

      Conclusions

      If fully implemented, intensive systolic BP lowering to < 120 mm Hg in SPRINT-eligible high-risk individuals would substantially increase the proportion of Canadian adults receiving BP treatment initiation or intensification.

      Résumé

      Contexte

      L'étude SPRINT (Systolic Blood Pressure Intervention Trial) a mis en évidence une diminution de la fréquence des événements cardiovasculaires majeurs et de la mortalité toutes causes confondues lorsque la cible de pression artérielle (PA) systolique était < 120 mm Hg plutôt que < 140 mm Hg. Nous avons voulu déterminer la proportion des adultes canadiens qui remplissent les critères d'admissibilité de l'étude SPRINT.

      Méthodologie

      Nous avons mené une étude transversale à partir des cycles 1 à 3 de l'Enquête canadienne sur les mesures de la santé, représentative à l'échelle nationale, pour estimer la prévalence et les caractéristiques des adultes canadiens âgés de 20 à 79 ans qui répondaient aux critères d'admissibilité de l'étude SPRINT: âge ≥ 50 ans, PA systolique élevée comprise entre 130 et 180 mm Hg et risque cardiovasculaire accru (avec néphropathie chronique, score de risque de Framingham ≥ 15 % sur 10 ans et/ou maladie cardiovasculaire) mais sans diabète, accident vasculaire cérébral ou insuffisance rénale terminale.

      Résultats

      Quelque 1,3 million (5,2 %) d'adultes canadiens répondaient aux critères d'admissibilité de l'étude SPRINT; 14,3 % (intervalle de confiance à 95 %: de 10,6 % à 17,9 %), soit 182 600 personnes, n'étaient pas considérées auparavant comme étant hypertendues ou nécessitant un traitement antihypertenseur. Chez les adultes âgés de 50 à 79 ans suivant un traitement contre l'hypertension, 18,7 % (intervalle de confiance à 95 %: de 15,5 % à 21,8 %), soit 754 400 personnes, pourraient bénéficier d'une intensification de leur traitement.

      Conclusions

      Si cette méthode était intégralement mise en oeuvre, la réduction intensive de la PA systolique à < 120 mm Hg chez les personnes à haut risque admissibles à l'étude SPRINT aurait pour effet d'augmenter de façon importante la proportion de Canadiens adultes chez lesquels un traitement antihypertenseur serait instauré ou intensifié.
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