Final SPRINT results confirm aggressive BP target reduces ri
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Lowering systolic BP to less than 120 mm Hg significantly reduced risk for MI, HF and CVD death compared with a systolic BP of less than 140 mm Hg, according to the final results of the SPRINT trial.

Researchers randomly assigned 9361 participants who were at increased risk for cardiovascular disease but did not have diabetes or previous stroke to adhere to an intensive treatment target (systolic blood pressure, less than 120 mm Hg) or a standard treatment target (systolic blood pressure, less than 140 mm Hg). The primary outcome was a composite of myocardial infarction, other acute coronary syndromes, stroke, acute decompensated heart failure, or death from cardiovascular causes. Additional primary outcome events occurring through the end of the intervention period were adjudicated after data lock for the primary analysis.

Results:
-- At a median of 3.33 years of follow-up, the rate of the primary outcome and all-cause mortality during the trial were significantly lower in the intensive-treatment group than in the standard-treatment group.

-- Serious adverse events of hypotension, electrolyte abnormalities, acute kidney injury or failure, and syncope were significantly more frequent in the intensive-treatment group.

-- When trial and post-trial follow-up data were combined (3.88 years in total), similar patterns were found for treatment benefit and adverse events; however, rates of heart failure no longer differed between the groups.

Conclusively, among patients who were at increased cardiovascular risk, targeting a systolic blood pressure of less than 120 mm Hg resulted in lower rates of major adverse cardiovascular events and lower all-cause mortality than targeting a systolic blood pressure of less than 140 mm Hg, both during receipt of the randomly assigned therapy and after the trial. Rates of some adverse events were higher in the intensive-treatment group.

Source: https://www.nejm.org/doi/full/10.1056/NEJMoa1901281
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