Benefit and Harm of Intensive Blood Pressure Treatment: Derivation and Validation of Risk Models Using Data from the Sprint and Accord Trials
2017
Intensive blood pressure (BP) treatment can avert cardiovascular disease (CVD) events but can cause some serious adverse events. The authors sought to create risk calculators to estimate individual patients’ chances of benefit and harm from intensive treatment.
They developed statistical models of cardiovascular events and serious adverse events from individual participant data from the Systolic Blood Pressure Intervention Trial (SPRINT) of intensive blood pressure treatment (N = 9,069 with complete covariate data) and validated them on individual participant data from the ACCORD-BP trial of intensive blood pressure treatment (N = 4,498 with complete covariate data). They used the models to calculate the absolute reduction in probability of CVD events (benefit) and absolute increase in probability of serious adverse events (harm) for individuals from intensive BP treatment. They found that the models could identify groups with high and with low absolute risk reduction in cardiovascular events and, similarly, identify groups with high and with low absolute risk increase in serious adverse events.
Source:
Basu S, Sussman JB, Rigdon J et al. Benefit and Harm of Intensive Blood Pressure Treatment: Derivation and Validation of Risk Models Using Data from the Sprint and Accord Trials. PLOS Medicine 2017; 14 (10): e1002410. https://doi.org/10.1371/journal.pmed.1002410