Based on new guideline from ACP and AAFP for the treatment of HTN in adults, published in Ann Intern Med 2017 Mar 21; 166:430.
For adults with SBP ≥ 160 mmHg, lowering the BP to < 150 mmHg, over a 5 year period:
- All-cause mortality: NNT = 61
- Stroke: NNT = 88.5
- Adverse cardiac events: NNT = 80
This guideline also concurs with the SPRINT trial that higher-risk patients (hx of CAD or hx of stroke/TIA) should be treated to a lower goal, but older patients (>60 yo) should be treated to <150 mmHg.
- Pt with hx of TIA/stroke, treating to 130-140 mmHg to prevent stroke (but not adverse cardiac events nor all-cause mortality): NNT = 33.1
- The evidence quality for stroke risk reduction is low to moderate.