Table 3.
Effect of Intensive Therapy on Seated, Standing, and Orthostatic SBP
| Trial |
Standard Goal (or Placebo) |
Low Goal (or Active Treatment) |
||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| BP treatment goal | Participants, n | Visits, n* | Mean Seated SBP (SD), mm Hg | Mean Standing SBP (SD), mm Hg | Difference (95% CI) | Participants, n | Visits, n* | Mean Seated SBP (SD), mm Hg | Mean Standing SBP (SD), mm Hg | Difference (95% CI) |
| AASK (19) | 553 | 23 986 | 142.1 (0.45) | 141.2 (0.50) | −0.87 (−1.42 to −0.32) | 537 | 24 785 | 131.7 (0.52) | 130.9 (0.54) | −0.80 (−1.33 to −0.27) |
| ACCORD BP (20) | 2119 | 3590 | 133.9 (0.26) | 136.7 (0.30) | 2.81 (2.40 to 3.23) | 2077 | 3572 | 120.1 (0.27) | 122.9 (0.30) | 2.79 (2.38 to 3.21) |
| SPRINT (18) | 4606 | 25 482 | 135.5 (0.12) | 137.2 (0.16) | 1.73 (1.49 to 1.96) | 4615 | 25 745 | 123.3 (0.13) | 125.3 (0.16) | 2.00 (1.77 to 2.22) |
| SPS3 (21) | 1443 | 9673 | 137.1 (0.27) | 140.2 (0.32) | 3.18 (2.73 to 3.62) | 1444 | 8420 | 129.9 (0.28) | 133.1 (0.33) | 3.24 (2.78 to 3.70) |
| UKPDS (9) | 359 | 899 | 160.7 (0.95) | 159.2 (0.99) | −1.64 (−2.52 to −0.76) | 713 | 1730 | 150.8 (0.65) | 149.0 (0.66) | −1.79 (−2.51 to −1.07) |
| Pooled effect of 5 treatment goal trials | 9080 | 63 630 | 136.9 (0.11) | 138.7 (0.13) | 1.82 (1.65 to 2.00) | 9386 | 64 252 | 126.3 (0.13) | 128.1 (0.14) | 1.84 (1.67 to 2.01) |
| Placebo-controlled | ||||||||||
| HYVET (22) | 1171 | 2219 | 159.6 (0.50) | 155.7 (0.49) | −3.91 (−4.25 to −3.57) | 1233 | 2513 | 145.3 (0.39) | 141.8 (0.40) | −3.57 (−3.88 to −3.27) |
| SHEP (23) | 2345 | 46 222 | 155.5 (0.26) | 154.2 (0.27) | −1.22 (−1.48 to −0.97) | 2336 | 43 134 | 142.4 (0.23) | 140.8 (0.25) | −1.66 (−1.92 to −1.40) |
| Syst-Eur (24) | 2244 | 18 377 | 162.7 (0.30) | 160.2 (0.31) | −2.41 (−2.63 to −2.19) | 2351 | 20 952 | 152.3 (0.22) | 149.8 (0.24) | −2.49 (−2.70 to −2.28) |
| TOMHS (25) | 234 | 3526 | 132.0 (0.76) | 130.3 (0.77) | −1.59 (−2.13 to −1.06) | 663 | 10 273 | 124.3 (0.43) | 122.1 (0.43) | −2.17 (−2.47 to −1.88) |
| Pooled effect of all 9 trials | 15 074 | 133 974 | 145.5 (0.14) | 145.7 (0.13) | 0.18 (0.05 to 0.30) | 15 969 | 141 124 | 134.2 (0.13) | 134.2 (0.13) | −0.00 (−0.12 to 0.11) |
AASK = African American Study of Kidney Disease and Hypertension; ACCORD BP = Action to Control Cardiovascular Risk in Diabetes: Blood Pressure; SPRINT = Systolic Blood Pressure Intervention Trial; SPS3 = Secondary Prevention of Small Subcortical Strokes; UKPDS = U.K. Prospective Diabetes Study; HYVET = Hypertension in the Very Elderly Trial; SHEP = Systolic Hypertension in the Elderly Program; Syst-Eur = Systolic Hypertension in Europe; TOMHS = Treatment of Mild Hypertension Study; SBP = systolic blood pressure.
*
Postrandomization follow-up visits.