ArticleBMJ (Clinical research ed.)2000
Using thresholds based on risk of cardiovascular disease to target treatment for hypertension: modelling events averted and number treated.
Article in BMJ (Clinical research ed.), 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2019Guideline
- Cardiovascular disease risk and comparison of different strategies for blood pressure management in rural India.BMC public health · 2018Trial
- Defining nonresponse to pulmonary rehabilitation by threshold scores for personality traits: a population-based study.ERJ open research · 2026Article
- Geographic and Sociodemographic Disparities in Cardiovascular Risk in Burkina Faso: Findings from a Nationwide Cross-Sectional Survey.Risk management and healthcare policy · 2021Article
- 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Circulation · 2019 · on this mapReview
- Eligibility and subsequent burden of cardiovascular disease of four strategies for blood pressure-lowering treatment: a retrospective cohort study.Lancet (London, England) · 2019Article
- Polypill therapy, subclinical atherosclerosis, and cardiovascular events-implications for the use of preventive pharmacotherapy: MESA (Multi-Ethnic Study of Atherosclerosis).Journal of the American College of Cardiology · 2014Article
- Article
- Management of High Blood Pressure in Those without Overt Cardiovascular Disease Utilising Absolute Risk Scores.International journal of hypertension · 2011Article
- Drugs for preventing cardiovascular disease in China.BMJ (Clinical research ed.) · 2005Article
- Description and validation of a Markov model of survival for individuals free of cardiovascular disease that uses Framingham risk factors.BMC medical informatics and decision making · 2004Article
- Using disease risk estimates to guide risk factor interventions: field test of a patient workbook for self-assessing coronary risk.Health expectations : an international journal of public participation in health care and health policy · 2002Article
- Meeting the National Service Framework for coronary heart disease: which patients have untreated high blood pressure?The British journal of general practice : the journal of the Royal College of General Practitioners · 2001Article
- Benefits of treating hypertension in the elderly: should age affect treatment decisions?Drugs & aging · 2001Review
- Risk in cardiovascular disease. Merit of using risk reduction rather than absolute risk for lipid lowering drugs.BMJ (Clinical research ed.) · 2000Article
- Guidelines on preventing cardiovascular disease in clinical practice.BMJ (Clinical research ed.) · 2000Article
- Statin use in Canadians: trends, determinants and persistence.Canadian journal of public health = Revue canadienne de sante publiqueArticle
- The Framingham Heart Study's impact on global risk assessment.Progress in cardiovascular diseasesArticle
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo estimate the impact of using thresholds based on absolute risk of cardiovascular disease to target drug treatment to lower blood pressure in the community.
designModelling of three thresholds of treatment for hypertension based on the absolute risk of cardiovascular disease. 5 year risk of disease was estimated for each participant using an equation to predict risk. Net predicted impact of the thresholds on the number of people treated and the number of disease events averted over 5 years was calculated assuming a relative treatment benefit of one quarter.
settingAuckland, New Zealand.
participants2158 men and women aged 35-79 years randomly sampled from the general electoral rolls.
main outcome measuresPredicted 5 year risk of cardiovascular disease event, estimated number of people for whom treatment would be recommended, and disease events averted over 5 years at different treatment thresholds.
results46 374 (12%) Auckland residents aged 35-79 receive drug treatment to lower their blood pressure, averting an estimated 1689 disease events over 5 years. Restricting treatment to individuals with blood pressure >/=170/100 mm Hg and those with blood pressure between 150/90-169/99 mm Hg who have a predicted 5 year risk of disease >/=10% would increase the net number for whom treatment would be recommended by 19 401. This 42% relative increase is predicted to avert 1139/1689 (68%) additional disease events overall over 5 years compared with current treatment. If the threshold for 5 year risk of disease is set at 15% the number recommended for treatment increases by <10% but about 620/1689 (37%) additional events can be averted. A 20% threshold decreases the net number of patients recommended for treatment by about 10% but averts 204/1689 (12%) more disease events than current treatment.
conclusionsImplementing treatment guidelines that use treatment thresholds based on absolute risk could significantly improve the efficiency of drug treatment to lower blood pressure in primary care.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.