{"id":6336,"date":"2025-04-08T18:05:28","date_gmt":"2025-04-08T15:05:28","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=6336"},"modified":"2025-04-08T18:05:28","modified_gmt":"2025-04-08T15:05:28","slug":"effect-of-frailty-on-intensive-blood-pressure-lowering-in-hypertensive-patients-at-high-cardiovascular-risk-post-hoc-analysis-of-the-esprit-trial","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/effect-of-frailty-on-intensive-blood-pressure-lowering-in-hypertensive-patients-at-high-cardiovascular-risk-post-hoc-analysis-of-the-esprit-trial\/","title":{"rendered":"Effect of Frailty on Intensive Blood Pressure Lowering in Hypertensive Patients at High Cardiovascular Risk \u2013 Post-hoc Analysis of the ESPRIT Trial"},"content":{"rendered":"
Effect of Frailty on Intensive Blood Pressure Lowering in Hypertensive Patients at High Cardiovascular Risk \u2013 Post-hoc Analysis of the ESPRIT Trial<\/div>\n
Source: Shitian Li, MD, presented at ACC.25 Scientific Session (March 2025)<\/div>\n
<\/div>\n
1. Background & Rationale<\/div>\n
\u2022 The ESPRIT trial previously showed that targeting SBP <120 mmHg significantly reduced MACE compared to <140 mmHg in high-risk hypertensive patients.<\/span><\/div>\n
\u2022 The impact of frailty status on the risk\u2013benefit balance of intensive BP control was unclear.<\/span><\/div>\n
<\/div>\n
2. Study Design<\/div>\n
\u2022 Post-hoc analysis of the ESPRIT trial, a multicenter, open-label, randomized controlled trial in China.<\/span><\/div>\n
\u2022 Included 11,255 hypertensive patients with high cardiovascular risk.<\/span><\/div>\n
\u2022 Randomized to:<\/span><\/div>\n
\u2022 Intensive treatment: target SBP <120 mmHg.<\/span><\/div>\n
\u2022 Standard treatment: target SBP <140 mmHg.<\/span><\/div>\n
\u2022 Median follow-up: 3.4 years.<\/span><\/div>\n
\u2022 Participants stratified by frailty index (FI):<\/span><\/div>\n
\u2022 Non-frail (FI \u2264 0.210): 19%<\/span><\/div>\n
\u2022 Moderately frail (FI 0.211\u20130.310): 51.3%<\/span><\/div>\n
\u2022 Severely frail (FI \u2265 0.311): 29.8%<\/span><\/div>\n
<\/div>\n
3. Key Endpoints<\/div>\n
\u2022 Primary outcome: Major adverse cardiovascular events (MACE) \u2014 composite of MI, revascularization, heart failure events, stroke, or cardiovascular death.<\/span><\/div>\n
\u2022 Secondary outcomes:<\/span><\/div>\n
\u2022 All-cause mortality.<\/span><\/div>\n
\u2022 Composite kidney outcome.<\/span><\/div>\n
\u2022 Safety outcomes: Hypotension, electrolyte abnormalities, falls with injury, and AKI.<\/span><\/div>\n
<\/div>\n
4. Main Findings<\/div>\n
\u2022 BP targets were reached similarly in the standard group regardless of frailty.<\/span><\/div>\n
\u2022 Frail patients in the intensive group reached targets more slowly, but final SBP\/DBP values were similar across all subgroups.<\/span><\/div>\n
\u2022 Frailty did not modify the effect of intensive vs. standard treatment on:<\/span><\/div>\n
\u2022 MACE<\/span><\/div>\n
\u2022 All-cause mortality<\/span><\/div>\n
\u2022 Kidney outcomes<\/span><\/div>\n
(All P for interaction > 0.05)<\/div>\n
\u2022 Adverse events were generally low and consistent across frailty groups, except for injurious falls, which were slightly more common in frail patients (P = 0.007).<\/span><\/div>\n
\u2022 Subgroup analysis by age (<70 vs \u226570 years) yielded consistent results.<\/span><\/div>\n
<\/div>\n
5. Conclusion<\/div>\n
\u2022 Intensive BP-lowering to SBP <120 mmHg is effective and generally safe in frail and non-frail hypertensive patients at high cardiovascular risk.<\/span><\/div>\n
\u2022 Estimated benefits (per 1000 severely frail patients treated for 3.4 years):<\/span><\/div>\n
\u2022 Prevents 30 MACE<\/span><\/div>\n
\u2022 Prevents 21 deaths<\/span><\/div>\n
\u2022 May cause 16 kidney outcomes and 7 injurious falls<\/span><\/div>\n
\u2022 Clinical Implication: Supports the use of intensive BP control regardless of frailty status.<\/span><\/div>\n","protected":false},"excerpt":{"rendered":"

Effect of Frailty on Intensive Blood Pressure Lowering in Hypertensive Patients at High Cardiovascular Risk \u2013 Post-hoc Analysis of the ESPRIT Trial Source: Shitian Li, MD, presented at ACC.25 Scientific Session (March 2025) 1. Background & Rationale \u2022 The ESPRIT trial previously showed that targeting SBP <120 mmHg significantly reduced MACE compared to <140 mmHg […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-6336","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/6336","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=6336"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/6336\/revisions"}],"predecessor-version":[{"id":6337,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/6336\/revisions\/6337"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=6336"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=6336"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=6336"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}