A Randomized Trial of Intensive versus Standard Blood-Pressure Control
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A Randomized Trial of Intensive versus Standard Blood-Pressure Control
Article Tools
The SPRINT Research Group
NEJM
November 9, 2015
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Age > 50
9361 persons with a systolic blood pressure of 130 mm Hg or higher and an increased cardiovascular risk, but without diabetes
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systolic blood-pressure target of less than 120 mm Hg (intensive treatment)
At 1 year, the mean systolic blood pressure was 121.4 mm Hg in the intensive-treatment group
2.8 medications
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systolic blood-pressure a target of less than 140 mm Hg (standard treatment)
At 1 year, the mean systolic blood pressure was 136.2 mm Hg in the standard-treatment group.
1.8 medications
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primary composite outcome (myocardial infarction, other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes) in the intensive-treatment group than in the standard-treatment group (1.65% per year vs. 2.19% per year; hazard ratio with intensive treatment, 0.75; 95% confidence interval [CI], 0.64 to 0.89; P<0.001).
All-cause mortality was also significantly lower in the intensive-treatment group (hazard ratio, 0.73; 95% CI, 0.60 to 0.90; P=0.003).
Rates of serious adverse events of hypotension, syncope, electrolyte abnormalities, and acute kidney injury or failure, but not of injurious falls, were higher in the intensive-treatment group than in the standard-treatment group.
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SPRINT was a randomized, controlled, open-label trial that was conducted at 102 clinical sites