@article{ea3cb38535844143af3c21fb60abb11c,
title = "Estimating systolic blood pressure intervention trial participant posttrial survival using pooled epidemiologic cohort data",
abstract = "BACKGROUND: Intensive systolic blood pressure treatment (<120 mm Hg) in SPRINT (Systolic Blood Pressure Intervention Trial) improved survival compared with standard treatment (<140 mm Hg) over a median follow-up of 3.3 years. We projected life expectancy after observed follow-up in SPRINT using SPRINT-eligible participants in the NHLBI-PCS (National Heart, Lung, and Blood Institute Pooled Cohorts Study). METHODS AND RESULTS: We used propensity scores to weight SPRINT-eligible NHLBI-PCS participants to resemble SPRINT participants. In SPRINT participants, we estimated in-trial survival (<4 years) using a time-based flexible parametric survival model. In SPRINT-eligible NHLBI-PCS participants, we estimated posttrial survival (≥4 years) using an age-based flexible parametric survival model and applied the formula to SPRINT participants to predict posttrial survival. We projected overall life expectancy for each SPRINT participant and compared it to parametric regression (eg, Gompertz) projections based on SPRINT data alone. We included 8584 SPRINT and 10 593 SPRINT-eligible NHLBI-PCS participants. After propensity weighting, mean (SD) age was 67.9 (9.4) and 68.2 (8.8) years, and 35.5% and 37.6% were women in SPRINT and NHLBI-PCS, respectively. Using the NHLBI-PCS– based method, projected mean life expectancy from randomization was 21.0 (7.4) years with intensive and 19.1 (7.2) years with standard treatment. Using the Gompertz regression, life expectancy was 11.2 (2.3) years with intensive and 10.5 (2.2) years with standard treatment. CONCLUSIONS: Combining SPRINT and NHLBI-PCS observed data likely offers a more realistic estimate of life expectancy than parametrically extrapolating SPRINT data alone. These results offer insight into the potential long-term effectiveness of intensive SBP goals.",
keywords = "Hypertension, Life expectancy, Survival",
author = "Bellows, {Brandon K.} and Yiyi Zhang and Zugui Zhang and Lloyd-Jones, {Donald M.} and Bress, {Adam P.} and King, {Jordan B.} and Paul Kolm and Cushman, {William C.} and Johnson, {Karen C.} and Leonardo Tamariz and Oelsner, {Elizabeth C.} and Steven Shea and Newman, {Anne B.} and Ives, {Diane G.} and David Couper and Moran, {Andrew E.} and Weintraub, {William S.}",
note = "Funding Information: Dr Bellows received funding for this analysis from the National Heart, Lung, and Blood Institute (NHLBI) (K01HL140170). Drs Moran, Bress, and Weintraub received funding for this analysis from the NHLBI (R01HL139837). Dr Bress also received funding from the NHLBI (K01HL133468). Dr Oelsner received funding for the NHLBI Pooled Cohorts Study from the NHLBI (R03HL132590). SPRINT (ClinicalTrials.gov number, NCT01206062) is funded by the NHLBI, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute on Aging, and the National Institute of Neurological Disorders and Stroke (contract numbers HHSN268200900040C, HHSN268200900046C, HHSN268200900047C, HHSN268200900048C, and HHSN268200900049C, and Interagency Agreement Number A-HL-13-002-001), through the Department of Veterans Affairs, and through Clinical and Translational Science Awards Programs funded by the National Center for Advancing Translational Sciences. The ARIC (Atherosclerosis Risk in Communities) has been funded in whole or in part with federal funds from the NHLBI, National Institutes of Health, Department of Health and Human Services, under contract numbers HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700004I, and HHSN268201700005I. CARDIA (Coronary Artery Risk Development in Young Adults Study) is conducted and supported by the NHLBI in collaboration with the University of Alabama at Birmingham (HHSN268201800005I and HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I). This article has been reviewed by CARDIA for scientific content. CHS (Cardiovascular Health Study) was supported by NHLBI contracts HHSN268201200036C, HHSN268200800007C, HHSN268201800001C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, and grants U01HL080295 and U01HL130114, with additional contribution from the National Institute of Neurological Disorders and Stroke. Additional support was provided by R01AG023629 from the National Institute on Aging. A full list of principal CHS investigators and institutions can be found at CHS-NHLBI.org. The FHS-O (Framingham Offspring) study is conducted and supported by the NHLBI in collaboration with Boston University (Contract No. N01-HC-25195 and HSN268201500001I). The Health ABC (Health, Aging, and Body Composition Study) study was supported by National Institute on Aging contracts N01-AG-6-2101, N01-AG-6-2103, N01-AG-6-2106, grant R01-AG028050, and National Institute of Nursing Research grant R01-NR012459. The MESA study (Multi-Ethnic Study of Atherosclerosis) was supported by NHLBI contracts HHSN268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168 and N01-HC-95169, and by National Center for Advancing Translational Sciences grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420. Funding Information: Dr Bellows received funding for this analysis from the National Heart, Lung, and Blood Institute (NHLBI) (K01HL140170). Drs Moran, Bress, and Weintraub received funding for this analysis from the NHLBI (R01HL139837). Dr Bress also received funding from the NHLBI (K01HL133468). Dr Oelsner received funding for the NHLBI Pooled Cohorts Study from the NHLBI (R03HL132590). SPRINT (Clini?calTr?ials.gov number, NCT01206062) is funded by the NHLBI, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute on Aging, and the National Institute of Neurological Disorders and Stroke (contract numbers HHSN268200900040C, HHSN268200900046C, HHSN268200900047C, HHSN268200900048C, and HHSN268200900049C, and Interagency Agreement Number A-HL-13-002-001), through the Department of Veterans Affairs, and through Clinical and Translational Science Awards Programs funded by the National Center for Advancing Translational Sciences. The ARIC (Atherosclerosis Risk in Communities) has been funded in whole or in part with federal funds from the NHLBI, National Institutes of Health, Department of Health and Human Services, under contract numbers HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700004I, and HHSN268201700005I. CARDIA (Coronary Artery Risk Development in Young Adults Study) is conducted and supported by the NHLBI in collaboration with the University of Alabama at Birmingham (HHSN268201800005I and HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I). This article has been reviewed by CARDIA for scientific content. CHS (Cardiovascular Health Study) was supported by NHLBI contracts HHSN268201200036C, HHSN268200800007C, HHSN268201800001C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, and grants U01HL080295 and U01HL130114, with additional contribution from the National Institute of Neurological Disorders and Stroke. Additional support was provided by R01AG023629 from the National Institute on Aging. A full list of principal CHS investigators and institutions can be found at CHS-NHLBI.org. The FHS-O (Framingham Offspring) study is conducted and supported by the NHLBI in collaboration with Boston University (Contract No. N01-HC-25195 and HSN268201500001I). The Health ABC (Health, Aging, and Body Composition Study) study was supported by National Institute on Aging contracts N01-AG-6-2101, N01-AG-6-2103, N01-AG-6-2106, grant R01-AG028050, and National Institute of Nursing Research grant R01-NR012459. The MESA study (Multi-Ethnic Study of Atherosclerosis) was supported by NHLBI contracts HHSN268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168 and N01-HC-95169, and by National Center for Advancing Translational Sciences grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420. Publisher Copyright: {\textcopyright} 2021 The Authors. Published on behalf of the American Heart Association, Inc.",
year = "2021",
doi = "10.1161/JAHA.120.020361",
language = "English (US)",
volume = "10",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "10",
}
