Individuals with lower baseline cardiovascular disease (CVD) risk had more harm than benefit from intensive treatment of hypertension, while those with higher risk had more benefit. This according to a study that examined the effect of baseline 10-year CVD risk on primary outcome events and all-cause serious adverse events (SAEs) in the Systolic Pressure Intervention Trial (SPRINT). Stratifying by quartiles of baseline 10-year CVD risk, Cox proportional hazards models were used to examine the associations of treatment group with primary outcomes events and SAEs. Researchers found:

• Within each quartile, there was a lower rate of primary outcome vents in the intensive treatment group, with no differences in all-cause SAEs.
• The number needed to treat to prevent primary outcomes decreased from 91 to 30 from the first to fourth quartiles.
• The number need to harm for all-cause SAEs increased from 62 to 250.
• There was significantly increasing benefit-to-harm ratio for the first, second, third, and fourth quartile, respectively.