Figure 3. 10-year number needed to treat for prevention of an incident composite CV event (ASCVD or HF, left panel) and HF (right panel) across 2017 ACC/AHA BP guideline recommended treatment groups stratified by biomarker status using the treatment effect of intensive BP control in SPRINT.

The red dotted line represents the 10-year NNT to prevent a composite CV event (left panel) and HF (right panel) for the group with stage 2 HTN (BP ≥160/100 mm Hg) (CV event = 22; HF = 43).

The 10-year number needed to treat (NNT¹⁰) to prevent an incident composite CV event and HF was estimated assuming a 25% and 38% relative risk reduction (RRR) in these outcomes, respectively, based on the treatment effect of intensive BP lowering to target systolic BP <120 mm Hg in SPRINT.

Elevated BP: 120–129/<80 mm Hg; stage 1 HTN: 130–139/80–89 mm Hg; stage 2 HTN: ≥140/90 mm Hg; high-risk stage 1 HTN was defined by the presence of any of the following: PCE-estimated 10-year ASCVD risk ≥10%, diabetes mellitus, estimated GFR <60 mL/min per 1.73 m², or age ≥65 years with systolic BP ≥130 mmHg; in the absence of all of these risk factors, individuals with stage 1 HTN were classified as low-risk; both biomarker (−): hs-cTnT <6 ng/L and NT-proBNP <100 pg/mL; hs-cTnT (+): hs-cTnT ≥6 ng/L; NT-proBNP (+): NT-proBNP ≥100 pg/mL; any biomarker (+): hs-cTnT ≥6 ng/L and/or NT-proBNP ≥100 pg/mL; composite CV event = non-fatal MI, non-fatal stroke, HF, or CV death.

Abbreviations: anti-HTN= antihypertensive; ASCVD = atherosclerotic cardiovascular disease; BP = blood pressure; CV = cardiovascular; GFR = glomerular filtration rate; HF = heart failure; hs-cTnT = high-sensitivity cardiac troponin T; HTN = hypertension; MI = myocardial infarction; NNT: number needed to treat; NT-proBNP = N-terminal pro-B-type natriuretic peptide; PCE = pooled cohort equation; SPRINT = Systolic Blood Pressure Intervention Trial.