Abstract 069: Antihypertensive Medication Treatment Regimens in SPRINT

Abstract

Background: Details of antihypertensive medication regimens used to achieve intensive systolic blood pressure (SBP) goals have not been described. Objective: Determine the distribution and longitudinal changes in antihypertensive medication regimens in the Systolic Blood Pressure Intervention Trial (SPRINT). Methods: We used antihypertensive medication data collected by pill bottle review at each visit to categorize antihypertensive regimens by medication class. Free text string variables of medication names were independently reviewed by two clinical pharmacists to create standardized generic medication names and classes. Results: Figure 1 illustrates longitudinal changes in class combinations and number of drugs at the randomization, 6, 12, and 18-month visits. Fifty-six percent of participants modified their initial regimen by the 6-month visits; 43% of participants made additional modifications to their regimens from the 6-month to the 18-month visit. The most common initial regimens, and least likely regimens to be changed over time, were combinations with an ACEI/ARB and diuretics ± other classes (42% of initial regimens). Participants in the intensive arm added a mean (standard deviation) of 0.6 (0.9) medications to their initial regimens in the first 18-months compared to -0.1 (0.9) in the standard arm. Conclusion: Intensive blood pressure treatment requires more medication complexity in terms of class and dose. Further study of distinct regimens may reveal if certain class and dose combinations provide better SBP control, safety, or patient satisfaction.