Landmark NIH Study SPRINT Shows Intensive Blood Pressure Management May Save Lives
Lower blood pressure target greatly reduces cardiovascular complications and deaths in older adults
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More intensive management of high blood pressure, below a commonly recommended blood
pressure target, significantly reduces rates of cardiovascular disease, and lowers
risk of death in a group of adults 50 years and older with high blood pressure. This
is according to the initial results of a landmark clinical trial sponsored by the
National Institutes of Health called the . The intervention in this trial, which carefully adjusts the amount or type of blood
pressure medication to achieve a target pressure of 120 millimeters of mercury (mm Hg), reduced rates of cardiovascular events,
such as heart attack and heart failure, as well as stroke, by almost a third and the
risk of death by almost a quarter, as compared to the target systolic pressure of
140 mm Hg.
鈥淭his 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,鈥� said Gary H. Gibbons, M.D., director of the
National Heart, Lung, and Blood Institute (NHLBI), the primary sponsor of SPRINT.
鈥淲e 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.鈥�
High blood pressure, or hypertension, is a leading risk factor for heart disease,
stroke, kidney failure, and other health problems. An estimated 1 in 3 people in the
United States has high blood pressure.
The SPRINT study evaluates the benefits of maintaining a new target for systolic
blood pressure, the top number in a blood pressure reading, among a group of patients
50 years and older at increased risk for heart disease or who have kidney disease.
A pressure of 120 mm Hg, maintained by this more intensive blood pressure intervention,
could ultimately help save lives among adults age 50 and older who have a combination
of high blood pressure and at least one additional risk factor for heart disease,
the investigators say.
The SPRINT study, which began in the fall of 2009, includes more than 9,300 participants
age 50 and older, recruited from about 100 medical centers and clinical practices
throughout the United States and Puerto Rico. It is the largest study of its kind
to date to examine how maintaining systolic blood pressure at a lower than currently
recommended level will impact cardiovascular and kidney diseases. NIH stopped the
blood pressure intervention earlier than originally planned in order to quickly disseminate
the significant preliminary results.
The study population was diverse and included women, racial/ethnic minorities, and
the elderly. The investigators point out that the SPRINT study did not include patients
with diabetes, prior stroke, or polycystic kidney disease, as other research included
those populations.
When SPRINT was designed, the well-established clinical guidelines recommended a
systolic blood pressure of less than 140 mm Hg for healthy adults and 130 mm Hg for
adults with kidney disease or diabetes. Investigators designed SPRINT to determine
the potential benefits of achieving systolic blood pressure of less than 120 mm Hg
for hypertensive adults 50 years and older who are at risk for developing heart disease
or kidney disease.
Between 2010 and 2013, the SPRINT investigators randomly divided the study participants
into two groups that differed according to targeted levels of blood pressure control.
The standard group received blood pressure medications to achieve a target of less
than 140 mm Hg. They received an average of two different blood pressure medications.
The intensive treatment group received medications to achieve a target of less than
120 mm Hg and received an average of three medications.
鈥淥ur 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,鈥�
said Lawrence Fine, M.D., chief, Clinical Applications and Prevention Branch at NHLBI.
鈥淏ut patients should talk to their doctor to determine whether this lower goal is
best for their individual care.鈥�
The study is also examining kidney disease, cognitive function, and dementia among
the patients; however, those results are still under analysis and are not yet available
as additional information will be collected over the next year. The primary results
of the trial will be published within the next few months.
In addition to primary sponsorship by the NHLBI, SPRINT is co-sponsored by the NIH鈥檚
National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute
of Neurological Disorders and Stroke, and the National Institute on Aging.
About the NHLBI
The National Heart, Lung, and Blood Institute (NHLBI) plans, conducts, and supports research related to the causes, prevention, diagnosis, and treatment of heart, blood vessel, lung, and blood diseases; and sleep disorders. The Institute also administers national health education campaigns on women and heart disease, healthy weight for children, and other topics. NHLBI press releases and other materials are available online at .
About the NIH
The National Institutes of Health (NIH) 鈥� The Nation's Medical Research Agency 鈥�
includes 27 Institutes and Centers and is a component of the U.S. Department of Health
and Human Services. It is the primary federal agency for conducting and supporting
basic, clinical and translational medical research, and it investigates the causes,
treatments, and cures for both common and rare diseases. For more information about
NIH and its programs, visit .