Treatment Recommendations Based on Benefit and Harm Experienced in SPRINT by 10-Year CVD Risk
With a benefit-to-harm ratio <1.00, the results suggest that for those in the first and second quartiles (<18.2%), intensive treatment would lead to greater harm of SAEs than benefit of reduced primary outcome events. By contrast, with a benefit-to-harm ratio >1.00, those in the third and fourth quartiles (≥18.2%) have greater benefit than harm from intensive treatment. While the 2017 ACC/AHA blood pressure guidelines recommend an intensive target SBP of <130 mm Hg for hypertensive patients with 10-year ACC/AHA CVD risk >10%, the results of the present analysis of SPRINT suggest a SBP target of <130 mm Hg would be appropriate for hypertensive individuals with 10-year CVD risk ≥18.2%. ACC = American College of Cardiology; AHA = American Heart Association; CVD = cardiovascular disease; SBP = systolic blood pressure.