Even When BP Readings Are Not Perfect, Targeting 120 mm Hg Still Pays Off

Background: Intensive systolic blood pressure (SBP) targets ( Objective: To determine how measurement error affects the cost-effectiveness of intensive SBP targets compared to less aggressive targets. Design: Microsimulation model study. Participants: Patients at high cardiovascular risk. Methods: The authors used a microsimulation model of SPRINT (Systolic Blood Pressure Intervention Trial) eligible, high cardiovascular risk patients, incorporating NHANES (National Health and Nutrition Examination Survey) and trial data, to compare SBP targets of Results: Targeting SBP of Intensive control reduced cardiovascular events and improved QALYs but increased medication use and adverse events. It became less cost-effective in scenarios with very high measurement error, greater medication burden, or increased cardiovascular risk at very low SBP. Conclusions: For high-risk patients without diabetes or prior stroke, SBP of Reviewer's Comments: I really liked the concept of a microsimulation bu more...