SPRINT-A Kidney-Centric Narrative Review: Recent Advances in Hypertension

Area of Science:

• Nephrology
• Cardiology
• Clinical Trials

Background:

• Hypertension is a major cardiovascular risk factor, prevalent in chronic kidney disease (CKD).
• The Systolic Blood Pressure Intervention Trial (SPRINT) investigated intensive blood pressure goals in high-cardiac-risk patients, including those with mild to moderate CKD.

Purpose of the Study:

• To evaluate the impact of an intensive systolic blood pressure goal (<120 mm Hg) on cardiovascular outcomes and mortality in patients with elevated cardiac risk, including those with CKD.
• To assess the effects of intensive blood pressure management on CKD progression and kidney function.

Main Methods:

• The SPRINT trial enrolled patients at elevated cardiac risk, with a subgroup having mild to moderate CKD.
• Participants were randomized to an intensive systolic blood pressure target (<120 mm Hg) or a standard target.

Main Results:

• Intensive systolic blood pressure control significantly reduced adverse cardiovascular events and all-cause mortality.
• These benefits were consistent across participants with and without CKD.
• Effects on CKD progression were inconclusive; some reversible kidney function decline and increased acute kidney injury were observed.

Conclusions:

• An intensive blood pressure target effectively reduces cardiovascular disease and all-cause mortality in patients with mild to moderate CKD.
• Potential benefits for probable dementia risk were noted.
• Further research is needed to clarify long-term effects on kidney function and CKD progression.