Blood Pressure Intervention and Control in SPRINT

Area of Science:

• Cardiology
• Clinical Trials
• Hypertension Management

Background:

• The Systolic Blood Pressure Intervention Trial (SPRINT) previously demonstrated cardiovascular benefits of intensive systolic blood pressure (SBP) reduction.
• A detailed account of the SPRINT intervention, including medication strategies and blood pressure control metrics, was lacking.

Purpose of the Study:

• To provide a comprehensive description of the SPRINT blood pressure intervention.
• To report on antihypertensive medication usage, achieved blood pressure levels, and factors influencing blood pressure control within the SPRINT trial.

Main Methods:

• 9361 hypertensive participants aged 50+ were randomized to SBP goals of <120 mm Hg (intensive) or <140 mm Hg (standard).
• Medications were provided free, with intensive group participants initiated on at least two drugs, adjusted monthly to reach goal.
• Standard group participants aimed for SBP of 135-139 mm Hg.

Main Results:

• Intensive group SBP reached <120 mm Hg in 61.6% and <130 mm Hg in 80.0% by the final visit, with medication use increasing from 2.2 to 2.7.
• Standard group SBP reached goal in 68.6% at 6 months, with medication use decreasing from 1.9 to 1.8.
• Median SBP remained stable from 6 to 36 months (intensive: 119±14 mm Hg; standard: 136±15 mm Hg), with few predictors of control identified.

Conclusions:

• The detailed intervention and outcomes of the SPRINT trial offer valuable insights for clinical practice.
• These findings can aid in replicating the cardiovascular benefits observed in SPRINT through effective blood pressure management strategies.