Gitsels, Lisanne;
Kulinskaya, Elena;
Bakbergenuly, Ilyas;
Steel, Nick;
(2018)
The ideal blood pressure: assessment of fixed and variant targets over time in clinical trial and routine clinical practice.
Presented at: International Biometric Conference 2018, Barcelona, Spain.
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Abstract
Recent evaluation of the research evidence on blood pressure thresholds for intervention by the Scottish Intercollegiate Guidelines Network (SIGN) and the American Heart Association (AHA) led to different updated hypertension guidelines. The question remains what the ideal blood pressure is in hypertensive patients. In clinical trials, blood pressure targets are fixed and blood pressure is treated accordingly during the intervention time, however this is done in a selective group of patients for a relatively short follow-up of less than five years. In routine clinical practice, patients are observed during most of their lifetime and sequential treatment decisions are made in treating blood pressure according to the latest guideline. These data qualities make the assessment of blood pressure targets complex. In this study, various Cox’s proportional hazards regression models were fitted to assess the time-variant effect of blood pressure targets on survival and chronic kidney disease outcomes (main adverse effect of antihypertensive treatment) using US Systolic Blood Pressure Intervention Trial (SPRINT) data and UK The Health Improvement Network (THIN) primary care data. The studied systolic blood pressure targets were <140 mmHg (standard treatment in routine clinical practice in the UK and previously also in the US) and <120 mmHg (intensive treatment). This work was supported by the Institute and Faculty of Actuaries (IFoA) and by the Business and Local Government Data Research Centre [grant ES/L011859/1].
| Type: | Conference item (Presentation) |
|---|---|
| Title: | The ideal blood pressure: assessment of fixed and variant targets over time in clinical trial and routine clinical practice |
| Event: | International Biometric Conference 2018 |
| Location: | Barcelona, Spain |
| Dates: | 08 - 13 July 2018 |
| Open access status: | An open access version is available from UCL Discovery |
| Publisher version: | https://2018.biometricconference.org/ |
| Language: | English |
| Keywords: | Longevity, Mortality, Treatment, Blood pressure, Time-variant |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10146409 |
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