Multifaceted Intensive Blood Pressure Control Model in Older and Younger Individuals With Hypertension: A Randomized Clinical Trial
Primary result · Total CVD, aged ≥60 yearsResult — go to the resultHazard ratio 0.75 95% CI 0.69–0.81Authors' conclusion
In both the aging and younger general population with hypertension, the nonphysician health care practitioner-led, multifaceted, intensive blood pressure intervention model could effectively and safely reduce the risk of cardiovascular disease and all-cause death.
Study context
- Population
- Patients with hypertension aged ≥60 years (and <60 years), 326 villages in rural China, 2018–202322,386 aged ≥60
- Participants
- 11,289 vs 11,097
- Comparison
- Nonphysician practitioner-led intensive BP intervention vs usual care
- Interventionn = 11,289
- Usual caren = 11,097reference
- Primary endpoint
- CVD (MI, stroke, HF requiring hospitalization, CVD death)
- Follow-up
- Median 4.0 years
Methodological detailsopen-cluster randomised, 48-month follow-up
- Open-cluster randomised
- 48-month follow-up
Primary result
Total CVD, aged ≥60 years · median 4.0 (IQR 4.0-4.1) years
Hazard ratio
0.75
95% CI 0.69–0.81
P < 0.001
Events by treatment group
Intervention vs Usual care
HR 0.75 (95% CI 0.69–0.81); P < 0.001
As reported in the abstract
Further findings
Per year
| Outcome | Intervention | Usual care | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| All-cause mortality, aged ≥60 years | 2.5% | 2.8% | 0.90 (0.83–0.98) | P = 0.01 | |
| Aged <60 years (subgroup) · total CVD | 0.64 (0.56–0.75) | P < 0.001 | |||
| Aged <60 years (subgroup) · stroke | 0.64 (0.55–0.76) | P < 0.001 | |||
| Aged <60 years (subgroup) · HF | 0.39 (0.18–0.87) | P = 0.02 | |||
| Aged <60 years (subgroup) · CV death | 0.54 (0.37–0.77) | P < 0.001 | |||
| 0.20.5125Hazard ratio (log scale) |
- Aged <60 years (subgroup): all interaction P values for age groups greater than .05
Safety
Injurious falls, symptomatic hypotension, syncope, kidney outcomes
- No significant difference between groups in either age category
Original publication
Multifaceted Intensive Blood Pressure Control Model in Older and Younger Individuals With Hypertension: A Randomized Clinical Trial. JAMA Cardiol. Published 1 September 2024. doi:10.
Summarised from the published abstract; every number is checked against it