CHS CHS Research & Evidence-Based Practice 1 — Questions and Answers
Question 1: Which landmark clinical trial demonstrated that intensive systolic blood pressure treatment to a target below 120 mmHg reduced cardiovascular events compared to a target of 140 mmHg?
- SPRINT trial (Correct answer)
- ACCORD trial
- HOT trial
- ALLHAT trial
Correct answer: SPRINT trial
The SPRINT (Systolic Blood Pressure Intervention Trial) trial showed that targeting systolic BP below 120 mmHg significantly reduced cardiovascular events and all-cause mortality.
Question 2: In evidence-based practice, what does the term 'NNT' (Number Needed to Treat) represent?
- The number of patients who must be treated to prevent one adverse event (Correct answer)
- The number of medications needed per patient
- The minimum dose needed to achieve target blood pressure
- The number of trials required to confirm efficacy
Correct answer: The number of patients who must be treated to prevent one adverse event
NNT is the number of patients who need to receive a treatment for a given duration to prevent one additional adverse outcome compared to control.
Question 3: The ALLHAT trial, the largest hypertension outcomes trial in US history, demonstrated that which antihypertensive class was equally or more effective than newer agents for preventing major CV outcomes?
- Thiazide diuretics (Correct answer)
- ACE inhibitors
- Calcium channel blockers
- ARBs
Correct answer: Thiazide diuretics
ALLHAT showed that chlorthalidone (a thiazide-type diuretic) was equivalent or superior to newer agents for preventing major cardiovascular outcomes, cementing its first-line status.
Question 4: Which study design provides the highest level of evidence for evaluating the effectiveness of antihypertensive treatments?
- Randomized controlled trial (RCT) (Correct answer)
- Case-control study
- Cross-sectional survey
- Expert opinion
Correct answer: Randomized controlled trial (RCT)
Randomized controlled trials provide the highest level of evidence for causality and treatment effectiveness because randomization minimizes confounding bias.
Question 5: What is the primary purpose of a meta-analysis in hypertension research?
- To pool results from multiple studies to increase statistical power and precision (Correct answer)
- To conduct a single large clinical trial
- To report a single patient's treatment outcomes
- To survey clinician practices about hypertension management
Correct answer: To pool results from multiple studies to increase statistical power and precision
A meta-analysis statistically combines data from multiple independent studies to generate more precise estimates of treatment effects than any individual study can provide.
Question 6: The HOT (Hypertension Optimal Treatment) trial investigated optimal diastolic blood pressure targets. What was its primary finding?
- Achieving a diastolic BP of ≤80 mmHg was associated with the lowest cardiovascular event rate in high-risk patients (Correct answer)
- Diastolic targets had no effect on outcomes
- Lower diastolic pressures universally increased stroke risk
- Only systolic targets matter in treatment decisions
Correct answer: Achieving a diastolic BP of ≤80 mmHg was associated with the lowest cardiovascular event rate in high-risk patients
The HOT trial found that targeting diastolic BP ≤80 mmHg produced the fewest cardiovascular events, particularly in diabetic patients, supporting tighter diastolic targets.
CHS CHS Research & Evidence-Based Practice 1
Which landmark clinical trial demonstrated that intensive systolic blood pressure treatment to a target below 120 mmHg reduced cardiovascular events compared to a target of 140 mmHg?