• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home The Classics General Medicine Classics

The SPRINT: Intensive vs. standard blood pressure control [Classics Series]

byAndrew Cheung, MD MBA
July 20, 2016
in General Medicine Classics, The Classics
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. In patients with hypertension and elevated cardiovascular risk, treating to a target systolic blood pressure of 120 mmHg significantly reduced the risk of heart failure and cardiovascular mortality when compared with the standard target of 140 mmHg.

2. Patients in the intensive group experienced significantly higher rates of hypotension, syncope, electrolyte abnormalities, and acute kidney injury compared to those in the standard group.

Original Date of Publication: November 2015

Study Rundown: The prevalence of hypertension has been estimated at approximately 1 billion globally. Prior studies have shown that treating hypertension significantly reduces the risk of stroke, myocardial infarction, and heart failure, though the blood pressure target for treatment remains unclear. Current guidelines generally recommend a target systolic blood pressure (sBP) of less then 130 to 150 mmHg, depending on a patient’s comorbidities. Lower sBP targets, however, have been linked with lower risk of cardiovascular outcomes.

The Systolic Blood Pressure Intervention Trial (SPRINT) explored the effects of lowering sBP to a target of 120 mmHg compared to a target of 140 mmHg in patients with hypertension and elevated cardiovascular risk. The study found that intensive treatment to an sBP target of 120 mmHg significantly reduced the risk of heart failure and cardiovascular mortality compared to a target of 140 mmHg. Patients in the intensive group also experienced significantly lower overall mortality. Compared to the standard target, patients in the intensive group experienced significantly higher rates of hypotension, syncope, electrolyte abnormalities, and acute kidney injury. It is important to note that patients with diabetes mellitus and previous stroke were excluded from this study.

Click to read the study in NEJM

In-Depth [randomized controlled trial]: Patients were eligible if they were ≥50 years of age, had sBP from 130-180 mmHg, and an increased risk of cardiovascular events (clinical/subclinical cardiovascular disease other than stroke, chronic kidney disease, 10-year Framingham risk ≥15%, ≥75 years of age). Patients with diabetes mellitus or prior stroke were not eligible. A total of 9361 patients were randomized to the standard-treatment group (sBP <140 mmHg) or the intensive-treatment group (sBP <120 mmHg). Treatment protocols encouraged, but did not mandate, the use of specific antihypertensives, including thiazides as first-line therapy, loop diuretics, and beta-blockers. The primary outcome was a composite of myocardial infarction, other acute coronary syndrome, stroke, acute decompensated heart failure, or cardiovascular death. Renal outcomes were also assessed separately in patients with and without chronic kidney disease. In patients with chronic kidney disease, this was a composite of a decrease in estimated glomerular filtration rate (eGFR) by ≥50% or end-stage renal disease requiring dialysis or transplantation. In those without, the outcome was a composite of a decrease in eGFR by ≥30% to <60 mL/min/1.73 m2.

RELATED REPORTS

Ultrasound renal denervation associated with reduced blood pressure in the RADIANCE II, RADIANCE-HTN SOLO, and RADIANCE-HTN TRIO trials – A pooled analysis

Endovascular ultrasound renal denervation associated with lower ambulatory systolic blood pressure in patients with hypertension – The RADIANCE II randomized clinical trial

Dietary insoluble fiber intake may be associated with lower risk of hypertension

The median follow-up was 3.26 years and the trial was stopped early. Throughout the follow-up period, mean sBP was 121.5 mmHg in the intensive group and 134.6 mmHg in the standard group. The mean number of antihypertensive medications used was 2.8 and 1.8 in the intensive and standard groups, respectively.

Patients in the intensive group experienced significantly lower rates of the primary outcome when compared with the standard group (HR 0.75, 95%CI 0.64 to 0.89, p < 0.001). This separation was apparent within the first year of follow-up, and was driven by reductions in heart failure (HR 0.62, 95%CI 0.45 to 0.84, p = 0.002) and cardiovascular death (HR 0.57, 95%CI 0.38 to 0.85, p = 0.005). The intensive group also experienced significantly fewer deaths compared to the standard group (HR 0.73, 95%CI 0.60 to 0.90, p = 0.003), and this difference became significant within 2 years after randomization. In patients with CKD, there were no significant differences between the groups in the renal outcome. In patients without CKD, those in the intensive group experienced significantly higher rates of eGFR decline than those in the standard group (HR 3.49, 95%CI 2.44 to 5.10, p < 0.001).

The rates of serious adverse events were similar in the two groups. The intensive group experienced significantly higher rates of hypotension (2.4% vs. 1.4%, p = 0.001), syncope (2.3% vs. 1.7%, p = 0.05), electrolyte abnormality (3.1% vs. 2.3%, p = 0.02), and acute kidney injury (4.1% vs. 2.5%, p < 0.001).

Image: PD

©2016 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: hypertensionsprint
Previous Post

2 Minute Medicine Rewind July 18, 2016

Next Post

Extending adjuvant letrozole treatment may reduce breast cancer recurrence: The MA.17R trial

RelatedReports

UTI associated with increased risk of preeclampsia
Cardiology

Ultrasound renal denervation associated with reduced blood pressure in the RADIANCE II, RADIANCE-HTN SOLO, and RADIANCE-HTN TRIO trials – A pooled analysis

March 6, 2023
Prevalence of hypertension among adolescents varies by race and BMI
Cardiology

Endovascular ultrasound renal denervation associated with lower ambulatory systolic blood pressure in patients with hypertension – The RADIANCE II randomized clinical trial

March 6, 2023
Provision of medically-tailored meals linked with lower admissions and medical spending
Cardiology

Dietary insoluble fiber intake may be associated with lower risk of hypertension

February 22, 2023
Prevalence of hypertension among adolescents varies by race and BMI
Cardiology

Telephone health coaching intervention ineffective for improving outcomes for hypertension

February 11, 2023
Next Post
Breast cancer chemoprevention may reduce mortality in lobular carcinoma-in-situ

Extending adjuvant letrozole treatment may reduce breast cancer recurrence: The MA.17R trial

Concomitant HPV vaccine administration equivalent to staggered schedule

Lower than expected seropositivity among vaccinated university students during N. meningitidis outbreak

Pediatric DKA associated with recent acute care visits

All glucose-lowering medications effective, but some offer lower hypoglycemia risks

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • SAR-CoV-2 infection during pregnancy may lead to adverse neurodevelopmental outcomes in male offspring
  • Hyperfractionated radiotherapy reduces complication rates compared to standard fractionation for locally advanced nasopharyngeal carcinoma
  • Lebrikizumab effective in treating moderate-to-severe atopic dermatitis
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options