SPRINT (secondary analysis)
Trial question
What is the long-term effect of intensive BP control in patients with hypertension?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
36.0% female
64.0% male
N = 9361
9361 patients (3332 female, 6029 male).
Inclusion criteria: patients ≥ 50 years of age with hypertension and increased cardiovascular risk.
Key exclusion criteria: 1 minute standing SBP < 110 mgHg; diabetes mellitus; history of stroke; polycystic kidney disease; cardiovascular event/procedure.
Interventions
N=4678 intensive BP control (SBP goal < 120 mmHg).
N=4683 standard BP control (SBP goal < 140 mmHg).
Primary outcome
Rate of CV death at a follow-up of 8.8 years
4.28%
4.25%
4.3 %
3.2 %
2.1 %
1.1 %
0.0 %
Intensive blood pressure
control
Standard blood pressure
control
No significant
difference ↔
No significant difference in the rate of CV death at a follow-up of 8.8 years (4.28% vs. 4.25%; HR 1.02, 95% CI 0.84 to 1.24).
Secondary outcomes
No significant difference in the rate of all-cause mortality at a follow-up of 8.8 years (13.5% vs. 12.6%; HR 1.08, 95% CI 0.94 to 1.23).
Borderline significant decrease in the rate of CV death at a follow-up of 3.3 years (1.36% vs. 1.96%; HR 0.66, 95% CI 0.49 to 0.89).
No significant difference in the rate of all-cause mortality at a follow-up of 3.3 years (5.2% vs. 6.2%; HR 0.83, 95% CI 0.68 to 1.01).
Conclusion
In patients ≥ 50 years of age with hypertension and increased cardiovascular risk, intensive BP control was not superior to standard BP control with respect to the rate of CV death at a follow-up of 8.8 years.
Reference
Byron C Jaeger, Adam P Bress, Joshua D Bundy et al. Longer-Term All-Cause and Cardiovascular Mortality With Intensive Blood Pressure Control: A Secondary Analysis of a Randomized Clinical Trial. JAMA Cardiol. 2022 Nov 1;7(11):1138-1146.
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