Impact of Selected Differences Between Automated versus Conventional Office Blood Pressure and Adherence on the Prevalence of SPRINT Eligibility in Korean Population

Abstract

Background: For the applicability of Systolic Blood Pressure (BP) Intervention Trial (SPRINT) is controversial due to regional cardiovascular (CV) risk stratification system, AHM adherence, and the automated office BP (AOBP) methodology.

Method: General population aged 30 or more (n=205282) and 55208 hypertension subject in Korean National Health Insurance Service - National Sample Cohort (NHIS-NSC) 2010 data were analyzed. Three BP criteria 1, 2, and 3 according to the selected difference between office BP and AOBP of 0 mmHg, 5 mmHg, and 10 mmHg, respectively. Also according to the risk groups and adherence status, prevalence of SPRINT eligible subjects were investigated.

Results: SPRINT eligibility subjects were observed in 6.5[6.4~6.7]% vs 5.6[5.5~5.7]% in the general population 15.9[15.7~16.0]% vs 14.8[14.7~15.0]% in hypertension patients by KSH vs. FRS, respectively ([ ], 95% confidence interval). According to BP criteria 1 to 3, SPRINT eligibilities by KSH were different significantly in the general population (6.5[6.4~6.7]%, 4.0[3.9~4.1]%, and 2.7[2.6~2.7]%, respectively) and in hypertension patients (15.9[15.7~16.0]%, 11.8[11.7~12.0]%, and 9.9[9.8~10.0]%, respectively). When the SPRINT eligibility was allowed only in PDC >= 300 days per year in hypertension patients, the prevalence according to the BP criteria 1 to 3 were 8.0[7.7~8.2]%, 5.4[4.3~4.7]%, and 4.1[3.9~4.2]%, respectively by KSH and 8.1[7.8~8.3]%, 5.7[5.5~5.9]%, and 4.4[4.3~4.6]%, respectively by FRS.

Conclusion: SPRINT eligibility can be markedly differed not by the risk stratification systems but by the application of AOBP to conventional office BP and adherence.