Suggestions(2)
Exact(4)
However, thresholds of 150 mm Hg or lower were associated with progressively decreased risk, down to a minimum intensification threshold of 130 mm Hg (supplementary table G).
We assumed that providers intensify antihypertensive treatment until the target blood pressure is reached and therefore used the minimum intensification threshold as a proxy for target blood pressure.
During the treatment strategy assessment period, we defined the minimum intensification threshold as the lowest systolic blood pressure at which antihypertensive medication intensification occurred (out of all known intensification events), rounded down to the nearest 10 mm Hg.
The sensitivity analysis for cohort effect showed no difference in the direction or significance of the associations between minimum intensification threshold, time to intensification, or time to follow-up and the composite outcome between patients with treatment strategy assessment period midpoint before compared with in or after 2000 (supplementary tables E and F).
Similar(55)
In this analysis, for patients without intensifications, we assumed that the highest blood pressure attained remained below the intensification threshold.
Transient blood pressure elevations, defined by a single elevated blood pressure measurement above the intensification threshold that fell below the threshold at the next blood pressure reading in the absence of medication intensification, were excluded from the analysis.
In the analysis of optimal systolic intensification threshold using a three year treatment strategy assessment period that included 329 491 patients, intensification thresholds above 150 mm Hg remained associated with increased risk of cardiovascular events or death.
A lower systolic blood pressure intensification threshold was associated with a progressively lower risk of the composite outcome.
No difference in risk of the outcome was seen between systolic intensification thresholds of 130-150 mm Hg, whereas systolic intensification thresholds greater than 150 mm Hg were associated with progressively greater risk (hazard ratio 1.21, 95% confidence interval 1.13 to 1.30; P<0.001 for intensification threshold of 160 mm Hg).
We found that systolic intensification thresholds higher than 150 mm Hg and delays of greater than 1.4 months before medication intensification after systolic blood pressure elevation above the intensification threshold were associated with an increased risk of an acute cardiovascular event or death.
We used a Cox proportional hazards regression model to compare event-free survival for patients with various treatment strategies as defined by systolic intensification threshold, time to intensification, and time to follow-up.
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