Trial reportHypertension (Dallas, Tex. : 1979)2023
Evidence for Age Bias Contributing to Therapeutic Inertia in Blood Pressure Management: A Secondary Analysis of SPRINT.
Trial report in Hypertension (Dallas, Tex. : 1979), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The trial behind it
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
7 citing papers in PubMed.
- Individualized Net Benefit of Intensive Blood Pressure Lowering Among Community-Dwelling Older Adults in SPRINT.Journal of the American Geriatrics Society · 2025Trial
- Incorporating Individual-Level Treatment Effects and Outcome Preferences Into Personalized Blood Pressure Target Recommendations.Journal of the American Heart Association · 2024Trial
- The survival penalty: Age-based inequities in hypertension and diabetes management in African health systems (1990-2022) - a secondary quantitative analysis.PLOS global public health · 2026Article
- Association of Questionnaire-Assessed Fall Risk With Uncontrolled Blood Pressure and Therapeutic Inertia Among Older Adults.Journal of clinical hypertension (Greenwich, Conn.) · 2025Article
- Optimal Blood Pressure Targets with Age.Clinics in geriatric medicine · 2024Review
- Age and Comorbidities Are Associated With Therapeutic Inertia Among Older Adults With Uncontrolled Blood Pressure.American journal of hypertension · 2024Article
- Therapeutic inertia.Australian prescriber · 2024Review
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Authors and funding
12 authors.
Funding
Abstract
backgroundDespite evidence supporting the cardiovascular and cognitive benefits of intensive blood pressure management, older adults have the lowest rates of blood pressure control. We determined the association between age and therapeutic inertia (TI) in SPRINT (Systolic Blood Pressure Intervention Trial), and whether frailty, cognitive function, or gait speed moderate or mediate these associations.
methodsWe performed a secondary analysis of SPRINT of participant visits with blood pressure above randomized treatment goal. We categorized baseline age as <60, 60 to <70, 70 to <80, and ≥80 years and TI as no antihypertensive medication intensification per participant visit. Generalized estimating equations generated odds ratios for TI associated with age, stratified by treatment group based on nested models adjusted for baseline frailty index score (fit [frailty index, ≤0.10], less fit [0.10<frailty index≤0.21], and frail [0.21<frailty index]), cognitive function by Montreal cognitive assessment, and gait speed (participants ≥75 years of age), separately.
resultsParticipants 60 to <70, 70 to <80, and ≥80 years of age had a higher prevalence of TI in both treatment groups versus participants <60 years of age (standard: 59.7%, 60.5%, and 60.1% versus 56.0%; 29 527 participant visits; intensive: 55.1%, 57.2%, and 57.8% versus 53.8%; 47 129 participant visits). The adjusted odds ratios for TI comparing participants ≥80 versus <60 years of age were 1.32 (95% CI, 1.14-1.53) and 1.25 (95% CI, 1.11-1.41) in the standard and intensive treatment groups, respectively. Adjustment for frailty, cognitive function, or gait speed did not attenuate the association or demonstrate effect modification (all
conclusionsOlder age is associated with greater TI independent of physical or cognitive function, implying age bias in hypertension management.
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