Landmark NIH Study Finds Intensive BP Management May Save Lives

By Sondra Forsyth

If you’ve been diagnosed with high blood pressure and you’re controlling it by keeping your systolic pressure under 140, you may need to get that number down to 120. That’s the finding of the Systolic Blood Pressure Intervention Trial (SPRINT) released September 11th 2015 by the National Institutes of Health. A release from the American College of Cardiology states that “more intensive management of high blood pressure (BP) may significantly reduce the rates of cardiovascular disease as well as the risk of death in patients 50 years and older with high BP.”

The release explains that in the trial, researchers examined over 9,300 patients aged 50 years or older with systolic blood pressure (SBP) ≥130 mm Hg and at least one additional cardiovascular disease risk factor in about 100 sites across the U.S. and Puerto Rico. Between 2010 and 2013, participants were randomized into two groups that differed according to targeted levels of BP control. The standard group received blood pressure medications to achieve a target of less than 140 mm Hg and 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. Primary outcomes were myocardial infarction (MI), acute coronary syndrome, stroke, heart failure, or cardiovascular disease death.

The researchers found that adjusting BP medication type and dosage to achieve a target SBP of 120 mm Hg, compared to a target SBP of 140mm Hg, reduced the rates of cardiovascular events such as MI, heart failure and stroke by almost a third and the risk of death by almost a quarter. At the start of the trial, clinical guidelines recommended a SBP of less than 140 mm Hg for healthy adults and 130 mm Hg for adults with kidney disease or diabetes.

The release quotes Gary H. Gibbons, MD, director of the National Heart, Lung, and Blood Institute, the primary sponsor of SPRINT, as saying, “This 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 the age of 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.”

NHLBI is working with the investigators to facilitate dissemination of the results.

“About 70 million American adults have high BP and only half of them have their condition under control. The preliminary data demonstrate why the cardiovascular community must continue to aggressively fight a condition that leads to stroke, kidney disease and heart problems for our patients,” said ACC President Kim Allan Williams Sr., MD, FACC. “The details of the SPRINT trial will be a contributing factor to future guidelines on BP treatment targets. In the meantime, these data give physicians more information to consider when working to improve outcomes for our patients with high BP.”