Lg. Ogden et al., Long-term absolute benefit of lowering blood pressure in hypertensive patients according to the JNC VI risk stratification, HYPERTENSIO, 35(2), 2000, pp. 539-543
Citations number
23
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Blood pressure (BP) levels alone have been traditionally used to make treat
ment decisions in patients with hypertension. The sixth report of the Joint
National Committee on Prevention, Detection, Evaluation, and Treatment of
High Blood Pressure (JNC VI) recently recommended that risk strata, in addi
tion to BP levels, be considered in the treatment of hypertension. We estim
ated the absolute benefit associated with a 12 mm Hg reduction in systolic
BP over 10 years according to the risk stratification system of JNC VI usin
g data from the National Health and Nutrition Examination Survey Epidemiolo
gic Follow-up Study. The number-needed-to-treat to prevent a cardiovascular
event/death or a death from all causes was reduced with increasing levels
of baseline BP in each of the risk strata. In addition, the number-needed-t
o-treat was much smaller in persons with greater than or equal to 1 additio
nal major risk factor for cardiovascular disease (risk group B) and in thos
e with a history of cardiovascular disease or target organ damage (risk gro
up C) than in those without additional major risk factors for cardiovascula
r disease (risk group A). Specifically, the number-needed-to-treat to preve
nt a death from all causes in patients with a high-normal BP, stage 1 hyper
tension, or stage 2 or 3 hypertension was, respectively, 81, 60, and 23 for
those in risk group A; 19, 16, and 9 for those in risk group B; and 14, 12
, and 9 for those in risk group C. Our analysis indicated that the absolute
benefits of antihypertensive therapy depended on BP as well as the presenc
e or absence of additional cardiovascular disease risk factors and the pres
ence or absence of preexisting clinical cardiovascular disease or target or
gan damage.