Systolic Blood Pressure Intervention Trial (SPRINT) Study

 

In adults age 50 and older who had high blood pressure and at least one additional cardiovascular disease risk factor, but who had no history of diabetes or stroke, SPRINT showed that treating to a target systolic blood pressure of less than 120 mm Hg reduced rates of high blood pressure complications, such as heart attack, heart failure, and stroke, by 25 percent. Compared with the standard target systolic pressure of 140 mm Hg, treating to less than 120 mm Hg also lowered the risk of death by 27 percent. In 2015, the SPRINT Research Group published its findings in the New England Journal of Medicine.

The cardiovascular benefits of the lower systolic blood pressure target were consistent in all groups of people included in SPRINT, regardless of gender, race, age, or pre-existing CKD. To achieve the target systolic blood pressure of less than 120 mm Hg, the first treatment group received three medicines on average. The second treatment group received two medicines to treat to the target systolic blood pressure of less than 140 mm Hg. Participants had high levels of satisfaction with treatment and adherence to medicines regardless of which treatment group they were in.

In the lower blood pressure group, there were expected side effects from blood pressure medicines, such as lower blood levels of potassium and sodium. Treating to the target systolic blood pressure of less than 120 mm Hg also showed an increase in complications due to low blood pressure such as fainting; however, there was not an increased risk of falls. Overall, the benefits in reducing the risk of cardiovascular disease and death outweighed the potential side effects of treating to a lower blood pressure target.

SPRINT included a large group of adults age 75 and older, and a separate analysis confirmed that treating to a lower blood pressure target reduced complications of high blood pressure and saved lives in older adults, as with the overall study population, even for older study participants who had poorer overall health. This was an important finding because a large percentage of the U.S. population age 75 and older have high blood pressure.

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