Overview

• Published August 18 in Annals of Internal Medicine, the peer-reviewed simulation modeled lifetime outcomes for targets of less than 120, 130, and 140 mm Hg using SPRINT and NHANES data.
• When typical clinic measurement error was included, the less-than-120 mm Hg goal still reduced heart attacks, strokes, and heart failure compared with the less-than-130 mm Hg goal.
• The intensive goal increased treatment-related harms, including falls, kidney injury, hypotension, and bradycardia.
• Medication use and clinic visits rose under the lower goal, yet the strategy remained cost-effective at roughly $42,000 per quality-adjusted life-year.
• Lead author Karen Smith said the results support intensive goals for high-risk patients with choices made through patient–clinician discussion, and the study reported funding from the National Science Foundation and the National Institute of Neurological Disorders and Stroke.