{"id":"bb83210074e0","type":"article","url":"https://hartvaat.nl/2023/07/01/leeftijdsbias-draagt-bij-aan-therapeutische-inertie-bij-bloeddrukmanagement/","title":"Leeftijdsbias draagt bij aan therapeutische inertie bij bloeddrukmanagement","title_en":"Evidence for Age Bias Contributing to Therapeutic Inertia in Blood Pressure Management: A Secondary Analysis of SPRINT.","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","huisarts","internist"],"tags":["bloeddrukbehandeling","bradycardie","hartrevalidatie","lichaamsbeweging","lichamelijke-inactiviteit","ouderen","summit-trial","vrouwen"],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.123.21323","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.123.21323","authors":["Alexander R Zheutlin","Daniel K Addo","Joshua A Jacobs","Catherine G Derington","Jennifer S Herrick","Tom Greene","Eric L Stulberg","Dan R Berlowitz","Jeff D Williamson","Nicholas M Pajewski","Mark A Supiano","Adam P Bress"],"significance":6,"published":"2023-07-01","source_date":"2023-07-01","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/resistente-hypertensie/","https://hartvaat.nl/kennis/hypertensie/behandeldoelen-bloeddruk/"],"congress":"","summary_en":"This SPRINT analysis showed that age bias contributes to therapeutic inertia in blood pressure management, with clinicians being less aggressive in intensifying treatment for older patients despite equal evidence of benefit.","created":"2026-07-03T10:30:27Z","updated":"2026-07-03T18:39:04Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"SPRINT-analyse toonde dat leeftijdsbias bijdraagt aan therapeutische inertie: artsen intensiveerden de bloeddrukbehandeling minder bij oudere patiënten ondanks vergelijkbaar voordeel. Dit draagt bij aan de onderbehandeling van hypertensie bij ouderen.","abstract_original":"BACKGROUND: Despite evidence supporting the cardiovascular and cognitive benefits of intensive blood pressure management, older adults have the lowest rates of blood pressure control. We determined the association between age and therapeutic inertia (TI) in SPRINT (Systolic Blood Pressure Intervention Trial), and whether frailty, cognitive function, or gait speed moderate or mediate these associations. METHODS: We performed a secondary analysis of SPRINT of participant visits with blood pressure above randomized treatment goal. We categorized baseline age as <60, 60 to <70, 70 to <80, and ≥80 years and TI as no antihypertensive medication intensification per participant visit. Generalized estimating equations generated odds ratios for TI associated with age, stratified by treatment group based on nested models adjusted for baseline frailty index score (fit [frailty index, ≤0.10], less fit [0.10<frailty index≤0.21], and frail [0.21<frailty index]), cognitive function by Montreal cognitive assessment, and gait speed (participants ≥75 years of age), separately. RESULTS: Participants 60 to <70, 70 to <80, and ≥80 years of age had a higher prevalence of TI in both treatment groups versus participants <60 years of age (standard: 59.7%, 60.5%, and 60.1% versus 56.0%; 29 527 participant visits; intensive: 55.1%, 57.2%, and 57.8% versus 53.8%; 47 129 participant visits). The adjusted odds ratios for TI comparing participants ≥80 versus <60 years of age were 1.32 (95% CI, 1.14-1.53) and 1.25 (95% CI, 1.11-1.41) in the standard and intensive treatment groups, respectively. Adjustment for frailty, cognitive function, or gait speed did not attenuate the association or demonstrate effect modification (all Pinteraction, >0.10). CONCLUSIONS: Older age is associated with greater TI independent of physical or cognitive function, implying age bias in hypertension management."}