SPRINT
Trial question
What is the role of intensive BP control in non-diabetic patients with hypertension at increased cardiovascular risk?
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 with a SBP ≥ 130 mmHg and an increased cardiovascular risk, but without diabetes
Key exclusion criteria: diabetes mellitus, prior stroke, or CKD
Interventions
N=4678 intensive BP reduction (systolic blood-pressure target of < 120 mmHg)
N=4683 standard BP management (systolic blood-pressure target of < 140 mmHg)
Primary outcome
Myocardial infarction, other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes
5.2
6.8
6.8 %
5.1 %
3.4 %
1.7 %
0.0 %
Intensive blood pressure
reduction
Standard blood pressure
management
Significant
decrease ▼
NNT = 62
Significant decrease in myocardial infarction, other acute coronary syndromes, stroke, HF, or death from cardiovascular causes (5.2% vs. 6.8%; HR 0.75, 95% CI 0.64 to 0.89)
Secondary outcomes
Significant decrease in death from any cause (3.3% vs. 4.5%; HR 0.73, 95% CI 0.6 to 0.9)
Safety outcomes
No significant differences in serious adverse events (38.3% vs. 37.1%, p=0.25).
Significant differences in serious adverse events as possibly or definitely related to the intervention (4.7% vs. 2.5%, p < 0.001), hypotension (2.4% vs. 1.4%, p = 0.001), and AKI or acute renal failure (4.1% vs. 2.5%, p < 0.001).
Conclusion
In patients with a SBP ≥ 130 mmHg and an increased cardiovascular risk, but without diabetes, intensive BP reduction was superior to standard BP management with respect to myocardial infarction, other acute coronary syndromes, stroke, HF, or death from cardiovascular causes.
Reference
SPRINT Research Group, Wright JT Jr, Williamson JD et al. A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med. 2015 Nov 26;373(22):2103-16.
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