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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Article Info
Publication History
Accepted:
January 11,
2018
Received:
December 12,
2017
Footnotes
See page 675 for disclosure information.
See editorial by Feldman, pages 543–545, and article by Goupil et al., pages 665–669 of this issue.
Identification
Copyright
© 2018 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
