SPRINT: lower blood pressure targets for many hypertensive

Original Title: A randomized trial of intensive versus standard blood-pressure control. Presenter: Wright JR Jr.

A systolic blood-pressure target lower than 120 over the standard 140 mm Hg reduces adverse events rates in non-diabetic patients at high cardiovascular risk, according to the SPRINT trial, but only at the expense of increased adverse events that include hypotension, syncope, electrolyte abnormalities and kidney injury or acute kidney failure.

The SPRINT trial, carried out in 102 centers across US, included 9,361 > 50 year oldpatients (mean agewas 68 years) with 130 to 180 mm Hg systolic blood pressure (mean 139.7 mm Hg) and high cardiovascular risk. Diabetics and patients with a history of stroke were excluded. The mean number of blood-pressure medications at baseline was 1.8, in both the intensive treatment group and the standard treatment group.

After one year, mean systolic blood pressure was 121.4 mm Hg in the intensive treatment group and 136.2 mm Hg in the standard treatment group; similar values were observed during the whole follow up period. The mean number of blood-pressure medications was 2.8 and 1.8, respectively.

There was a 25% reduction of relative risk and an absolute risk reduction of nearly 0.5% in the combined end point with the lowest blood pressure target.