SPRINT

SPRINT

What is the role of intensive BP control in nondiabetic hypertensive patients who are at an increased cardiovascular risk?

Study design

Population

• 9361 patients (3332 female, 6029 male)
• Inclusion criteria: patients with a systolic BP ≥ 130 mmH and an increased cardiovascular risk, but without diabetes
• Key exclusion criteria: diabetes mellitus, prior stroke, or CKD

Interventions

• N=4678 intensive BP reduction (systolic blood-pressure target of < 120 mmHg)
• N=4683 standard BP management (systolic blood-pressure target of < 140 mmHg)

Primary outcome

Significant decrease in myocardial infarction, other ACSs, stroke, HF, or death from cardiovascular causes (5.2% vs. 6.8%; HR 0.75, 95% CI 0.64 to 0.89)

Secondary outcomes

Significant decrease in death from any cause (3.3% Vs. 4.5%; HR 0.73, 95% CI 0.6 to 0.9)

Safety outcomes

• No significant differences in serious adverse events (38.3% vs. 37.1%, p=0.25).
• Significant differences in serious adverse events as possibly or definitely related to the intervention (4.7% vs. 2.5%, p < 0.001), hypotension (2.4% vs. 1.4%, p =0.001), and AKI or acute renal failure (4.1% vs. 2.5%, p < 0.001).

Conclusion

In patients with a systolic BP ≥ 130 mmH and an increased cardiovascular risk, but without diabetes, intensive BP reduction was superior to standard BP management with respect to myocardial infarction, other ACSs, stroke, HF, or death from cardiovascular causes.