In adults with hypertension without diabetes, lowering their systolic blood pressure (SBP) target to less than 120 mm Hg, as compared to less than 140 mm Hg, may lower the rate of cardiovascular events and all-cause mortality, according to results from the SPRINT Trial presented Nov. 9 during AHA 2015 in Orlando and simultaneously published in the New England Journal of Medicine.

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In the trial, researchers examined over 9,300 patients aged 50 years or older with SBP of 130 to 180 mm Hg with an increased risk of cardiovascular events in about 100 sites across the U.S. and Puerto Rico. Patients were randomized to either a standard group, with a target of less than 140 mm Hg, or an intensive-treatment group, with a target of less than 120 mm Hg.

Results showed that after one year, the mean SBP was 121.4 mm Hg in the intensive-treatment group, and 136.2 mm Hg in the standard-treatment group. The intervention was stopped early due to a"significantly lower rate" of the primary composite outcome of myocardial infarction, other acute coronary syndromes, stroke, heart failure, or cardiovascular disease death, in the intensive-treatment group (1.65 percent per year vs. 2.19 percent per year; hazard ratio with intensive treatment, 0.75; confidence interval [CI], 0.64 to 0.89; P<0.001). Further, all-cause mortality was also significantly lower in the intensive-treatment group.

In a separate generalizability study published in the Journal of the American College of Cardiology, authors found that more than 16.8 million U.S. adults, 7.6 percent of the population, could be recommended for intensive blood pressure (BP) management if future guidelines incorporate a lower SBP target based on the SPRINT Trial results.

"Future guidelines on BP treatment targets will take the SPRINT trial results into consideration," said ACC President Kim Allan Williams Sr., MD, FACC." In the meantime, these data give physicians more information to consider when working to improve outcomes for patients with high BP."

Keywords: Acute Coronary Syndrome, Blood Pressure, Diabetes Mellitus, Heart Failure, Hypertension, Myocardial Infarction, National Heart, Lung, and Blood Institute (U.S.), Stroke, Confidence Intervals

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