Generalizability of SPRINT Results to the U.S. Adult Population.
Generalizability of SPRINT Results to the U.S. Adult Population.
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DOI：
10.1016/j.jacc.2015.10.037
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发表时间：
2016-02-09
影响因子：
24
通讯作者：
Muntner P
中科院分区：
文献类型：
--
作者：
Bress AP;Tanner RM;Hess R;Colantonio LD;Shimbo D;Muntner P
在收缩压干预试验（SPRINT）中，收缩压（SBP）目标值<120 mmHg与目标值<140 mmHg相比，心血管疾病（CVD）风险更低。
本研究的目的是评估符合SPRINT入选标准的美国成年人的患病率、数量和特征，并确定SPRINT可推广到的更广泛人群。
我们利用2007年至2012年美国国家健康与营养检查调查的数据进行了一项基于人群的横断面研究。SPRINT的纳入标准为年龄≥50岁，收缩压130 - 180 mmHg（取决于正在服用的降压药类别数量），以及心血管疾病高风险（冠心病病史、估计的肾小球滤过率为20 - 59 ml/min/1.73 m²、10年心血管疾病风险≥15%，或年龄≥75岁）。排除标准为糖尿病、中风病史、每日蛋白尿>1 g、心力衰竭、估计的肾小球滤过率<20 ml/min/1.73 m²，或正在接受透析。治疗性高血压定义为通过自我报告使用降压药物，且通过药瓶检查确定使用了≥1类降压药物。
总体而言，7.6%（95%置信区间[CI]：7.0% - 8.3%），即1680万（95% CI：1570万 - 1780万）美国成年人，以及16.7%（95% CI：15.2% - 18.3%），即820万（95% CI：760万 - 880万）患有治疗性高血压的成年人符合SPRINT入选标准。在美国总体人群和患有治疗性高血压的成年人中，符合SPRINT入选标准的百分比随年龄增长而增加，男性高于女性，非西班牙裔白人高于非西班牙裔黑人或西班牙裔。在符合SPRINT标准的美国成年人中，51.0%（95% CI：47.8% - 54.1%），即860万（95% CI：800万 - 910万）未接受高血压治疗。
相当比例的美国成年人符合SPRINT的入选标准。
In SPRINT (Systolic Blood Pressure Intervention Trial), a systolic blood pressure (SBP) goal of <120 mm Hg resulted in lower cardiovascular disease (CVD) risk compared with an SBP goal of <140 mm Hg. The purpose of this study was to estimate the prevalence, number, and characteristics of U.S. adults meeting SPRINT eligibility criteria and determine the broader population to whom SPRINT could be generalized. We conducted a cross-sectional, population-based study using data from the National Health and Nutrition Examination Survey, 2007 to 2012. The SPRINT inclusion criteria were age ≥50 years, SBP 130 to 180 mm Hg depending on the number of antihypertensive medication classes being taken, and high CVD risk (history of coronary heart disease, estimated glomerular filtration rate of 20 to 59 ml/min/1.73 m2, 10-year CVD risk ≥15%, or age ≥75 years). Exclusion criteria were diabetes, history of stroke, >1 g in 24 h of proteinuria daily, heart failure, estimated glomerular filtration rate <20 ml/min/1.73 m2, or receiving dialysis. Treated hypertension was defined by self-reported use of medication to lower blood pressure with ≥1 class of antihypertensive medication identified through a pill bottle review. Overall, 7.6% (95% confidence interval [CI]: 7.0% to 8.3%) or 16.8 million (95% CI: 15.7 to 17.8 million) U.S. adults, and 16.7% (95% CI: 15.2% to 18.3%) or 8.2 million (95% CI: 7.6 to 8.8 million) adults with treated hypertension met the SPRINT eligibility criteria. Among both the overall U.S. population and adults with treated hypertension, the percentage meeting SPRINT eligibility criteria increased with older age, was higher among males than females, and was higher among non-Hispanic whites compared with non-Hispanic blacks or Hispanics. Of U.S. adults eligible for SPRINT, 51.0% (95% CI: 47.8% to 54.1%) or 8.6 million (95% CI: 8.0 to 9.1 million) were not treated for hypertension. A substantial percentage of U.S. adults meet the eligibility criteria for SPRINT.