Reduction in Systolic Blood Pressure Considered Important Hypertension Treatment Choice

Christine Poulos, PhD

A recent analysis aimed to apply discrete choice experiment methods to quantify patient benefit-risk preferences for hypertension treatments, including interventional and pharmaceutical treatments.

Led by Christine Poulos, PhD, Global Head of Health Preference Assessment, RTI Health Solutions, investigators observed a reduction in office systolic blood pressure was the most important driver of treatment choices and was considered greater than safety concerns related to drugs and interventional treatment and preference for no intervention over intervention.

The study was presented online at the Virtual Transcatheter Cardiovascular Therapeutics Conference.

Methods

In the analysis, respondents with physician confirmed uncontrolled hypertension chose between hypothetical hypertension treatments involving a procedure and/or pills.

Investigators noted the treatment feature options included interventional or non-interventional treatment, number of daily blood pressure pills, expected reduction in office systolic blood pressure, duration of effect, risk of drug side effects, risk of access site pain, and risk of vascular injury.

Each different level of each feature was also identified to address patient response to different levels of benefit and risk. The team noted that respondents were also offered an option of no hypertension treatment.

Then, a random parameters logit model calculated the relative importance of each treatment attribute. Investigators identified treatment profiles based on sham-controlled renal denervation (RDN) clinical trials developed to assess the impact of patient preference on overall hypothetical treatment choice.

Additionally, the questionnaire assessed comprehension and response consistency of the respondents in order to evaluate data quality.

Findings

A total of 400 patients completed the questionnaire, of which the demographic data included 52% female patients, with a mean age of 59.2 ± 13.0 years. Further, data included a mean systolic blood pressure of 155.1±12.3 mmHg, while 1.8±0.9 were prescribed antihypertensive medications.

The majority of respondents (72%) answered all 10 of the comprehension questions correctly, while 92% of respondents correctly selected a superior treatment over an inferior alternative. Poulos and colleagues noted this suggested a good understanding of the questionnaire.

In addition, the most important treatment attribute was identified as a reduction in office systolic blood pressure. Then, the remaining attributes were considered less impactful, including duration of effect, whether treatment was interventional, number of daily pills, risk of vascular injury, and risk of drug side effects. Data show respondents to the questionnaire preferred blood pressure treatment over no treatment.

Takeaways

“Based on these findings, a model using safety and efficacy outcomes from SPYRAL clinical trials determined that a majority of respondents with uncontrolled hypertension would choose an interventional procedure such as RDN if it would help them achieve their BP goals,” investigators wrote.

The study, “Patient preferences for interventional and pharmaceutical treatments among U.S. adults with uncontrolled hypertension,” was published online by TCT.