HypertensionSecondary analysis
The Effect of Frailty on the Efficacy and Safety of Intensive Blood Pressure Control: A Post Hoc Analysis of the SPRINT Trial
- Post hoc analysis of the SPRINT randomised trial
- subgroup analysis
Authors' conclusion
Frailty status was a marker of high cardiovascular risk. Patients with frailty benefit similarly to other patients from intensive blood pressure control without an increased risk of serious adverse events.
Study context
- Population
- SPRINT participants (mean age, 67.9±9.4 years)561 primary outcomes
- Participants
- 9,306 participants
- Comparison
- Intensive vs standard BP control, by frailty status
- Frailtyn = 2,560
- Primary endpoint
- Composite of:
- Myocardial infarction
- Acute coronary syndrome without myocardial infarction
- Stroke
- Heart failure
- Cardiovascular death
- Follow-up
- Median 3.22 years
Primary result
As reported in the abstract
Primary outcome: frailty vs no frailty, within each BP arm
Frailty vs No frailtyAdjusted hazard ratio (95% CI)
intensive BP control arm
2.10(1.59–2.77)
standard BP control arm
1.85(1.46–2.35)
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| CV death, intensive treatment effect by frailty (subgroup) — Intensive vs Standard · Frailty | 0.91 (0.52–1.60) | |
| CV death, intensive treatment effect by frailty (subgroup) — Intensive vs Standard · No frailty | 0.30 (0.16–0.59) | |
| 0.10.31310Hazard ratio (log scale) |
- CV death, intensive treatment effect by frailty (subgroup): Pinteraction=0.01
Safety
Serious adverse events with intensive treatment, by frailty
- No significant interaction between frailty and risks for serious adverse events with intensive treatment
Original publication
The Effect of Frailty on the Efficacy and Safety of Intensive Blood Pressure Control: A Post Hoc Analysis of the SPRINT Trial. Circulation. Published 4 July 2023. doi:10.1161/circulationaha.123.064003
Summarised from the published abstract; every number is checked against it