01
What the evidence says
SPRINT randomized 9,361 adults with elevated cardiovascular risk, but without diabetes or prior stroke, to systolic targets below 120 or below 140 mm Hg. The trial stopped early after a median 3.26 years because the intensive strategy reduced the primary cardiovascular outcome and all-cause mortality. Serious adverse events overall were similar, while some events such as hypotension, electrolyte abnormalities, and acute kidney injury were more frequent.
Sources for this section: [1]
02
How to use the finding
The finding supports shared decisions for people resembling participants and able to receive close monitoring. Blood pressure was measured using a standardized research protocol that can differ from hurried routine readings. A target is therefore tied to how pressure is measured, medicine tolerance, falls, kidney function, other conditions, and the resources available for dose changes and laboratory checks.
Sources for this section: [1]
03
Limits and open questions
SPRINT excluded diabetes, prior stroke, nursing-home residents, and several other groups, so it cannot answer every target question. Early stopping can magnify apparent benefit, and the average result does not mean every participant benefited. Later analyses are useful, but the core decision remains a balance between absolute cardiovascular benefit and each person’s probability of treatment harm.
Sources for this section: [1]
Sources
- A Randomized Trial of Intensive versus Standard Blood-Pressure ControlNew England Journal of Medicine · 2015DOI 10.1056/NEJMoa1511939