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Comment & Response
November 8, 2016

Intensive vs Standard Blood Pressure Control for Older Adults

Author Affiliations
  • 1Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Boston, Massachusetts

Copyright 2016 American Medical Association. All Rights Reserved.

JAMA. 2016;316(18):1921. doi:10.1001/jama.2016.14909

To the Editor Contrary to widespread concerns about the detrimental effects of intensive blood pressure control in frail older adults, the investigators of SPRINT reported that the beneficial effect was consistent across frailty level in the subgroup of patients aged 75 years or older.1 These findings are similar to those from a retrospective analysis of the Hypertension in the Very Elderly Trial.2 In both analyses, the investigators adopted the deficit accumulation approach proposed by Rockwood and Mitnitski3 to quantify frailty from symptoms, signs, disease, disability, and diagnostic test results measured at the baseline examination, without requiring more time-consuming performance tests as in other frailty assessments.