To the Editor The SPRINT Research Group1 provided evidence to guide antihypertensive management practice in persons aged 75 years or older. However, we are concerned about the generalizability of the study and the nature of the outcome measures used.
The authors acknowledged that their findings cannot be applied to patients with a number of common chronic conditions (including diabetes, history of stroke, heart failure, and dementia) who were excluded from the study for pragmatic reasons. However, in patients aged 75 years or older, some of these comorbidities have a population prevalence as high as 20%, with rates that continue to increase.2 In addition, although polypharmacy was not an exclusion criteria, a number of potential participants were excluded due to “taking too many medications.”
Dimitri M, Janus E, Karunajeewa H. Intensive vs Standard Blood Pressure Control for Older Adults. JAMA. 2016;316(18):1921-1922. doi:10.1001/jama.2016.14921