Time to SPRINT to Lower Blood Pressure Target?

A target systolic blood pressure (SBP) of 120 mm Hg has outperformed the recommended 140 mm Hg target in the landmark SPRINT study.

A target systolic blood pressure (SBP) of 120 mm Hg has outperformed the recommended 140 mm Hg target in the landmark SPRINT study.

Current guidelines, including the JNC 8 hypertension guidelines, have recommended a target SBP <140 mm Hg for most patients and <150 mm Hg for those over age 60.

However, the results of the Systolic Blood Pressure Interventional Trial (SPRINT) show a clear benefit in targeting an SBP of 120 mm Hg instead of 140 mm Hg in adults over age 50 with cardiovascular comorbidities.

SPRINT is one of the largest hypertension trials ever conducted, enrolling 9300 patients aged 50 or older at 100 medical centers and clinical practice sites in the United States and Puerto Rico. Importantly, the study included patients of diverse ethnic background and elderly patients.

All patients enrolled in SPRINT had hypertension and an additional heart disease-related risk factor, and they were monitored since fall 2009. Patients achieved the 120 mm Hg systolic blood pressure goal using an average of 3 blood pressuring-lowering medications, while those remaining on standard treatment used an average of 2 medications.

The study was stopped early after an interim analysis detected an overwhelming benefit with the 120 mm Hg SBP goal over the 140 mm Hg goal.

“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,” stated Lawrence Fine, MD, chief of the Clinical Applications and Prevention Branch at the National Heart Lung and Blood Institute.

However, Dr. Fine noted, “Patients should talk to their doctor to determine whether this lower goal is best for their individual care.”

The SPRINT results were announced on September 11, 2015, but formal results remain unpublished as of this writing. They do not necessarily apply to those with diabetes, a prior stroke, or polycystic kidney disease, as patients with these conditions were excluded from the trial.