Blood Pressure Intervention and Control in SPRINT

William C. Cushman, Robert J. Ringer, Carlos J. Rodriguez, Gregory W. Evans, Jeffrey T. Bates, Jeffrey A. Cutler, Amret Hawfield, Dalane W. Kitzman, Ilya M. Nasrallah, Suzanne Oparil, John Nord, Vasilios Papademetriou, Karen Servilla, Peter Van Buren, Paul K. Whelton, Jeff Whittle, Jackson T. Wright

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The SPRINT (Systolic Blood Pressure Intervention Trial) demonstrated reductions in major cardiovascular disease events and mortality with an intensive systolic blood pressure (SBP) goal intervention. However, a detailed description of the blood pressure intervention, antihypertensive medication usage, blood pressure levels, and rates and predictors of blood pressure control has not been reported previously. Methods: Hypertensive participants (n=9361) 50 years and older with elevated cardiovascular disease risk were randomized 1:1 to SBP goal <120 mm Hg or SBP goal <140 mm Hg. Guideline-recommended antihypertensive medications and dosing were provided at no cost. Intensive group participants were started on at least 2 medications, and medications were adjusted monthly until SBP goal was achieved, if feasible. Standard group participants were treated to achieve SBP 135 to 139 mm Hg. Results: Baseline blood pressure (median±interquartile range) was 138±19/78±16 mm Hg. For intensive group participants, percent at goal rose from 8.9% at baseline to 52.4% at 6 months and average antihypertensive medications rose from 2.2 to 2.7; SBP was <120 mm Hg in 61.6% and <130 mm Hg in 80.0% at their final visit. For the standard group participants, percent at goal rose from 53.0% at baseline to 68.6% at 6 months, while antihypertensive medications fell from 1.9 to 1.8. From 6 to 36 months, median SBP was stable at 119±14 mm Hg for intensive and 136±15 mm Hg for standard participants, with stable numbers of medications. Few predictors of SBP control were found in multiple regression models. Conclusions: These results may inform and help replicate the benefits of SPRINT in clinical practice. Registration: URL: http://www.clinicaltrials.gov; Unique identifier: NCT01206062.

Original languageEnglish (US)
Pages (from-to)2071-2080
Number of pages10
JournalHypertension
Volume79
Issue number9
DOIs
StatePublished - Sep 1 2022

Keywords

  • antihypertensive agents
  • blood pressure control
  • cardiovascular diseases
  • hypertension
  • randomized controlled trial

ASJC Scopus subject areas

  • Internal Medicine

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