Impact of the SPRINT Trial on Hypertension Management

Ghazi, Lama; Oparil, Suzanne

doi:10.1146/annurev-med-050416-024516

Cited by 6 publications

(4 citation statements)

References 84 publications

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“…Hypertension is a health disorder that affects a large part of the population worldwide. High blood pressure (BP) is considered the main risk factor for cardiovascular disease (CVD) [39]. Epidemiological studies have shown an association between hypertension, CVD and PD [40].…”

Section: Hypertension and Cardiovascular Diseasementioning

confidence: 99%

Is periodontal disease a risk factor for severe COVID-19 illness?

et al. 2020

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Periodontal disease (PD) comprises a group of diseases involving inflammatory aspects of the host and dysbiotic events that affect periodontal tissues and could have systemic implications. Diverse factors and comorbidities have been closely associated with PD such as diabetes, obesity, aging, hypertension, and so on; although, underlying mechanisms or causal associations have not been established completely. Interestingly, these same factors have been widely associated with progression or severe coronavirus disease 2019 (COVID-19), an illness caused by coronavirus SARS-CoV-2. Since inflammatory and dysbiotic factors as well as comorbidities affect systemic health, it is possible that periodontal status indicates the risk of complication of COVID-19. However, assessment of oral health history including periodontal status in COVID-19 patients has not been reported. Knowing PD is associated with severe COVID-19 could help identify risk groups and establish pertinent recommendations. Evaluation of hypothesis: Shared risk factors by PD and severe COVID-19 illness AgingAging is considered a process that causes degenerative changes at the cellular level and sometimes leads to various diseases that can be

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Section: Hypertension and Cardiovascular Diseasementioning

confidence: 99%

Is periodontal disease a risk factor for severe COVID-19 illness?

et al. 2020

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“…The SPRINT and ACCORD clinical trials were two significant studies that shaped the most recent ACC/AHA guidelines. They, however, had certain limitations that may have affected their results: (1) The SPRINT trial showed a better cardiovascular outcome among the treatment group that received intensive treatment (aiming for systolic BP < 120 mmHg) compared with a standard treatment group (systolic BP < 140 mmHg), excluded individuals with end-stage chronic kidney disease (glomerular filtration rate < 20 mL/min/m 2 and proteinuria > 1 g/day), diabetes, and population in nursing homes or had dementia resulting in lack of generalizability (external validity) [ 14 ], and (2) The ACCORD BP trial revealed that tight BP control showed no advantage over standard therapy. However, many scholars felt the study was "underpowered" because of its design [ 14 ].…”

Section: Reviewmentioning

confidence: 99%

“…Reducing diastolic BP below 60 mm Hg in those with CAD may magnify the risk of adverse cardiovascular events. The guidelines failed to address the issues of lowering diastolic BP [ 14 ].…”

Section: Reviewmentioning

confidence: 99%

The Evolution of Hypertension Guidelines Over the Last 20+ Years: A Comprehensive Review

Evbayekha¹,

Okobi²,

Okobi³

et al. 2022

Cureus

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Hypertension is the most common modifiable risk factor for cardiovascular and cerebrovascular diseases. In the last two decades, the guidelines have evolved tremendously from areas with no recommendations for screening or treatment to targeted recommendations for some at-risk groups. We sought to go through the literature that provided guidelines for the management of hypertension at any point in time over the last 22 years from 2000 to 2022. We searched four databases: PubMed, Embase, Google Scholar, and Cochrane, using specified search terms. The keywords used were "hypertension" and "guidelines." We combined them using the Boolean operators (AND, OR) and searched for articles. A total of 2461 publications were initially identified; 348 publications were excluded after screening for full-text availability. The full-text articles were further filtered based on title and abstract screening. Following this, a total of 1443 articles were excluded. The remaining 670 full-text articles were assessed for eligibility. Of the 670 full-text articles, 480 were excluded based on exclusion criteria, and following the full-text article screening, 190 articles met the final inclusion criteria. Most of these guideline evolutions concerned establishing and adjusting thresholds for the subgroups of the elderly population and patients with diabetic kidney disease, chronic kidney disease, and stroke. Furthermore, the medications of choice are now guided by the stage of disease, presence or absence of comorbidities, and other relevant information, as opposed to ethnicity, which was previously a heavy yardstick for medication choice.

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“…This study was motivated by increasing interest in understanding the relationships between BP and glaucoma, particularly because BP management guidelines have evolved in recent years. This is largely due to clinical trials such as the Systolic Blood Pressure Intervention Trial (SPRINT) [ 23 ], which showed that intensive systolic BP control to less than 120 mmHg was significantly beneficial to overall health. Some investigators have posited that intensive BP control may be specifically beneficial to glaucoma patients because a decrease in BP of 10 mmHg within five years led to a decrease in IOP [ 24 ], a known risk factor for glaucoma.…”

Section: Discussionmentioning

confidence: 99%

Assessing Usability of Smartwatch Digital Health Devices for Home Blood Pressure Monitoring among Glaucoma Patients

et al. 2022

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Glaucoma is a leading cause of blindness worldwide. Blood pressure (BP) dysregulation is a known risk factor, and home-based BP monitoring is increasingly used, but the usability of digital health devices to measure BP among glaucoma patients is not well studied. There may be particular usability challenges among this group, given that glaucoma disproportionately affects the elderly and can cause visual impairment. Therefore, the goal of this mixed-methods study was to assess the usability of a smart watch digital health device for home BP monitoring among glaucoma patients. Adult participants were recruited and given a smartwatch blood pressure monitor for at-home use. The eHEALS questionnaire was used to determine baseline digital health literacy. After a week of use, participants assessed the usability of the BP monitor and related mobile app using the Post-study System Usability Questionnaire (PSSUQ) and the System Usability Scale (SUS), standardized instruments to measure usability in health information technology interventions. Variations in scores were evaluated using ANOVA and open-ended responses about participants’ experience were analyzed thematically. Overall, usability scores corresponded to the 80th–84th percentile, although older patients endorsed significantly worse usability based on quantitative scores and additionally provided qualitative feedback describing some difficulty using the device. Usability for older patients should be considered in the design of digital health devices for glaucoma given their disproportionate burden of disease and challenges in navigating digital health technologies, although the overall high usability scores for the device demonstrates promise for future clinical applications in glaucoma risk stratification.

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Impact of the SPRINT Trial on Hypertension Management

Cited by 6 publications

References 84 publications

Is periodontal disease a risk factor for severe COVID-19 illness?

Is periodontal disease a risk factor for severe COVID-19 illness?

The Evolution of Hypertension Guidelines Over the Last 20+ Years: A Comprehensive Review

Assessing Usability of Smartwatch Digital Health Devices for Home Blood Pressure Monitoring among Glaucoma Patients

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