HypertensionSecondary analysis
Heart Stress and Blood Pressure Management in Older Adults: Post Hoc Analysis of the ASPREE Trial
- Post hoc analysis of the ASPREE randomised trial
- landmark sensitivity analysis
Authors' conclusion
HS is common in older adults and jointly associated with hypertension and increased CVD risk. The SBP-CVD relationship differs by HS status, suggesting a potential value of HS for guiding individualized BP management.
Study context
- Population
- Community-dwelling older adults without cardiovascular disease (CVD) at enrollment (mean age 75.1 years; 53.5% women); Heart stress (HS) = NT-proBNP ≥150 pg/mL (65–74 years) or ≥300 pg/mL (≥75 years)
- Participants
- 11,941 adults
- Comparison
- Hypertension and heart stress categories vs no hypertension or HS
- Primary endpoint
- Total CVD events:
- Nonfatal MI
- Fatal or nonfatal stroke
- CHD death
- Hospitalization for HF
Primary result
As reported in the abstract
Total CVD events
Each group vs no hypertension or HSAdjusted hazard ratio (95% CI)
Hypertension + no HS
1.41(1.18–1.70)
No hypertension + HS
1.79(1.34–2.39)
Hypertension + HS
2.32(1.89–2.84)
Further findings
Prevalence of HS
- HS present
- 25.8%
Systolic BP (SBP) and total CVD events, no HS (subgroup)
- U-shaped association; lowest incidence at SBP 130 to 139 mm Hg
- Pnonlinearity=0.011
SBP and total CVD events, HS (subgroup)
- Risk increased linearly with SBP; lowest at SBP <120 mm Hg
- P for linear trend = 0.85
Landmark analyses
- Generally consistent findings
Original publication
Heart Stress and Blood Pressure Management in Older Adults: Post Hoc Analysis of the ASPREE Trial. Circulation. Published 22 October 2025. doi:10.1161/circulationaha.125.076263
Summarised from the published abstract; every number is checked against it