Let's Not SPRINT to Judgment About New Blood Pressure Goals
Authors: Eduardo Ortiz, Paul A. James
Journal: Annals of Internal Medicine (2016)

Letters20 December 2016Let's Not SPRINT to Judgment About New Blood Pressure GoalsEduardo Ortiz, MD, MPH and Paul A. James, MDEduardo Ortiz, MD, MPHFrom Washington, DC; University of Iowa, Iowa City, Iowa. and Paul A. James, MDFrom Washington, DC; University of Iowa, Iowa City, Iowa.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0442 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Lewis and colleagues and appreciate their perspective. They suggest that we understated the benefits and exaggerated the harms from SPRINT (1). We agree that relative risk reduction is an important measure of clinical effect. However, it is incomplete and should be interpreted in the context of absolute risk reduction (2), which does not confound the effect size of the intervention with the baseline risk for an event. We stand by our assertion that the interpretation of clinical trial results should be more balanced and use established principles of evidence-based medicine to assess clinical effectiveness.SPRINT ...References1. Wright JT, Williamson JD, Whelton PK, Snyder JK, Sink KM, Rocco MV, et al; SPRINT Research Group. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373:2103-16. [PMID: 26551272] doi:10.1056/NEJMoa1511939 CrossrefMedlineGoogle Scholar2. Carrasco-Labra A, Montori VM, Ioannidis JA, Jaeschke R, Devereaux P, Walsh M, et al. Misleading presentations of clinical trial results. In: Guyatt G, Rennie D, Meade MO, Cook DJ, eds. Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice. 3rd ed. New York: McGraw-Hill; 2015:259-70. Google Scholar3. Olsen LA, McGinnis JM. Roundtable on Value and Science-Driven Health Care. Redesigning the Clinical Effectiveness Research Paradigm: Innovation and Practice-Based Approaches: Workshop Summary. Washington, DC: National Academies Pr; 2010. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Washington, DC; University of Iowa, Iowa City, Iowa.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-3123. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLet's Not SPRINT to Judgment About New Blood Pressure Goals Eduardo Ortiz and Paul A. James Let's Not SPRINT to Judgment About New Blood Pressure Goals Cora E. Lewis , Karen C. Johnson , Mahboob Rahman , Kaycee M. Sink , and Walter T. Ambrosius Metrics Cited byPros and Cons of Intensive Systolic Blood Pressure LoweringEffect of Intensive Blood-Pressure Treatment on Patient-Reported Outcomes 20 December 2016Volume 165, Issue 12Page: 889-890KeywordsAbsolute risk reductionBlood pressureClinical trialsConflicts of interestDecision makingDisclosureEvidence based medicineRelative risk ePublished: 20 December 2016 Issue Published: 20 December 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...