The trial included adults 50 years and older with high blood
pressure. It found that adjusting blood pressure medications to achieve a
target top number of 120 millimeters of mercury (mm Hg) reduced rates of
cardiovascular events by almost a third, and the risk of death by almost a
quarter, compared with targeting a top number of 140 mm Hg. (Cardiovascular
events include heart attack, heart failure and stroke.)
Loyola University Medical Center enrolled 89 patients in the
National Institutes of Health study, called the Systolic Blood Pressure
Intervention Trial (SPRINT). Initial results were announced Sept. 11.
“This is the first clinical trial to confirm that a more
intensive blood pressure regimen improves cardiovascular outcomes,” said Holly
Kramer, MD, principal investigator at the Loyola site, along with
co-investigator Vinod K. Bansal, MD. Dr. Kramer is an associate professor in
the Department of Public Health Sciences and Division of Nephrology and Dr.
Bansal is a professor in the Division of Nephrology of Loyola University
Chicago Stritch School of Medicine.
Gary H. Gibbons, MD, director of the National Heart, Lung, and
Blood Institute, the primary sponsor of SPRINT, said: “The 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 age 50. We 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.”
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 systolic 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 from about 100 medical centers and clinical
practices throughout the United States and Puerto Rico. It is the largest study
of its kind to examine how maintaining systolic blood pressure at a lower than
currently recommended level will affect 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.
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.
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