Blood pressure responder rates versus goal rates: which metric matters?

Full Abstract

Reducing blood pressure (BP) to guideline-recommended goals associated with reductions in cardiovascular risk is central to effective hypertension management. In addition to measuring BP reduction, clinical trials of antihypertensive agents should assess the percentage of patients responding to treatment. The Food and Drug Administration's defined rate of response required for drug approval is a reduction in diastolic BP (DBP) to <90 mmHg and/or a DBP reduction of > or = 10 mmHg. Consequently, some patients may be counted as responders even if they have not reached DBP <90 mmHg. An antihypertensive agent's effectiveness may be better assessed by the proportion of patients who achieve recommended BP goals. This article analyzes the frequency of response rates versus goal rates as endpoints in randomized trials since January 2001. Data showed that goal rates, especially combined systolic BP (SBP)/DBP goal rates, are consistently lower than response rates in studies evaluating both endpoints. Goal rates incorporating both SBP and DBP, or having a focus on SBP for individuals >50 years of age, provide the most clinically relevant information and are a more clinically relevant metric of an agent's ability to reduce BP than DBP alone.

Author information

Author/s: Basile, Jan (J);

Affiliation: Ralph H. Johnson VA Medical Center, Charleston, SC, USA. Jan.Basile(-atsign-)med.va.gov

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review

Journal: Therapeutic advances in cardiovascular disease (Ther Adv Cardiovasc Dis), published in England. (Language: eng)

Reference: 2009-Apr; vol 3 (issue 2) : pp 157-74

Dates: Created 2009/03/20; Completed 2009/05/28;

PMID: 19299428, status: MEDLINE (last retrieval date: 5/28/2009, IMS Date: 28 May 2009 00:00:00)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Antihypertensive Agents - administration & dosage
Blood Pressure - drug effects
Goals
Hypertension - drug therapy

Associated Chemicals: Antihypertensive Agents (0)

This article has not been indexed for related articles as yet, however you can still use the live related article search links below.

See 100+ related articles.

See a large map of 100+ related articles.