Intensive Blood Pressure Management Greatly Reduces Cardiovascular Events, Death

Treatment for high blood pressure should be more aggressive with a target lower than commonly recommended by guidelines, according to a study from the National Institutes of Health.

The Systolic Blood Pressure Intervention Trial (SPRINT) found that adjusting blood pressure medication to achieve a target systolic pressure of 120 mm Hg, instead of the recommended 140 mm Hg, reduced rates of cardiovascular events and stroke by almost a third, and the risk of death by almost a quarter.

“This study provides potentially lifesaving information that will be useful to health care providers as they consider the best treatment options for some of their patients, particularly those over the age of 50,” Gary H. Gibbons, MD, director of the National Heart, Lung, and Blood Institute, the primary sponsor of SPRINT, said in a statement. “We are delighted to have achieved this important milestone in the study in advance of the expected closure date for the SPRINT trial and look forward to quickly communicating the results to help inform patient care and the future development of evidence-based clinical guidelines.”

SPRINT randomly assigned more than 9300 men and women aged 50 years and older to either a target of less than 120 or less than 140. Given the importance of the results, the study has been stopped earlier than originally planned so a paper on the preliminary results can be written and published in the next few months.

It is estimated that one-third of people in the United States has high blood pressure, which is a leading risk factor for heart disease, stroke, kidney failure, and other health problems. This more intensive blood pressure intervention could ultimately save lives among older adults who have a combination of high blood pressure and at least one additional risk factor for heart disease, according to the investigators.

“Our results provide important evidence that treating blood pressure to a lower goal in older or high-risk patients can be beneficial and yield better health results overall,” said Lawrence Fine, MD, chief of the Clinical Applications and Prevention Branch at NHLBI. “But patients should talk to their doctor to determine whether this lower goal is best for their individual care.”