Background: Recent data from SPRINT trial demonstrated that, intense systolic blood pressure (ISBP) control to <120 mm Hg was associated with lower cardiovascular morbidity and mortality, compared to standard systolic BP (St-SBP) control to <140 mm Hg. We sought to determine current trend in the clinical practice in terms of intense SBP control.
Methods: Electronic medical records from 3 different ambulatory clinics were reviewed to identify hypertensive patients with at least 3 consecutive clinic visits. Patients with diabetes, with <3 clinic visits, end-stage renal failure, and end stage liver failure were excluded. Cohort was categorized in to ISBP group and St-SBP group, when more than 50% of the clinic encounters had SBP ≤ 120 mm HG and > 120 mm Hg respectively.
Results: 1644 non diabetic patients with HTN included in the analysis. 1389 (84.5%) patients had St-SBP control whereas only 255 (15.5%) patients had ISBP control. ISBP group had significantly lower mean (±SD) SBP compared to St-SBP group; 116(±6.4) mm Hg vs. 136(±11.6) mm Hg respectively; P<0.0001. Baseline characteristics shown in table 1. ISBP group and St-SBP group had similar comorbid profile, except slightly greater prevalence of COPD in ISBP 46 (18.0%) vs 165 (11.9%); P=0.007.
Conclusion: There is significant variation in SBP control in non-diabetic hypertensive patients in clinical practice, despite comparable comorbid profile. Furthermore, ISBP control is not a common practice in real world. Quality improvement measures should focus on promoting ISBP control in non-diabetic hypertensive patients.