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Interpreting Key Trials

Interpreting SPRINT: How low should you go?

George Thomas, MD, FACP, FASN, Joseph V. Nally, MD and Marc A. Pohl, MD
Cleveland Clinic Journal of Medicine March 2016, 83 (3) 187-195; DOI: https://doi.org/10.3949/ccjm.83a.15175
George Thomas
Director, Center for Blood Pressure Disorders, Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic
Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
Cleveland Clinic Site Principal Investigator, Systolic Blood Pressure Intervention Trial (SPRINT)
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  • For correspondence: thomasg3@ccf.org
Joseph V. Nally
Director, Center for Chronic Kidney Disease, Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic
Clinical Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
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Marc A. Pohl
Ray W. Gifford Chair in Hypertension, Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic
Chair, Clinical Management Committee, Irbesartan Diabetic Nephropathy Trial
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ABSTRACT

The Systolic Blood Pressure Intervention Trial (SPRINT) found evidence of cardiovascular benefit with intensive lowering of systolic blood pressure (goal < 120 mm Hg) compared with the currently recommended goal (< 140 mm Hg) in older patients with cardiovascular risk but without diabetes or stroke. This article reviews the trial design and protocol, summarizes the results, and briefly discusses the implications of these results.

  • Copyright © 2016 The Cleveland Clinic Foundation. All Rights Reserved.
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REFERENCES

  1. ↵
    1. SPRINT Research Group
    2. Wright JT Jr.,
    3. Williamson JD,
    4. Whelton PK,
    5. et al
    . A randomized trial of intensive versus standard blood-pressure control. N Engl J Med 2015; 373:2103–2116.
    OpenUrlCrossRefPubMed
  2. ↵
    1. Yoon SS,
    2. Fryar CD,
    3. Carroll MD
    . Hypertension prevalence and control among adults: United States, 2011–2014. NCHS data brief, no. 220. Hyattsville, MD: National Center for Health Statistics. 2015
  3. ↵
    1. Franklin SS,
    2. Jacobs MJ,
    3. Wong ND,
    4. L’Italien GJ,
    5. Lapuerta P
    . Predominance of isolated systolic hypertension among middle-aged and elderly US hypertensives: analysis based on National Health and Nutrition Examination Survey (NHANES) III. Hypertension 2001; 37:869–874.
    OpenUrlCrossRef
  4. ↵
    1. Neal B,
    2. MacMahon S,
    3. Chapman N,
    4. Blood Pressure Lowering Treatment Trialists’ Collaboration
    . Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospectively designed overviews of randomised trials. Blood Pressure Lowering Treatment Trialists’ Collaboration. Lancet 2000; 356:1955–1964.
    OpenUrlCrossRefPubMed
  5. ↵
    1. Psaty BM,
    2. Smith NL,
    3. Siscovick DS,
    4. et al
    . Health outcomes associated with antihypertensive therapies used as first-line agents. A systematic review and meta-analysis. JAMA 1997; 277:739–745.
    OpenUrlCrossRefPubMed
  6. ↵
    1. Lewington S,
    2. Clarke R,
    3. Qizilbash N,
    4. Peto R,
    5. Collins R,
    6. Prospective Studies Collaboration
    . Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360:1903–1913.
    OpenUrlCrossRefPubMed
  7. ↵
    1. SHEP Cooperative Research Group
    . Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension: final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 1991; 265:3255–3264.
    OpenUrlCrossRefPubMed
  8. ↵
    1. Staessen JA,
    2. Fagard R,
    3. Thijs L,
    4. et al
    . Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. The Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Lancet 1997; 350:757–764.
    OpenUrlCrossRefPubMed
  9. ↵
    1. Beckett NS,
    2. Peters R,
    3. Fletcher AE,
    4. et al
    5. HYVET Study Group
    . Treatment of hypertension in patients 80 years of age or older. N Engl J Med 2008; 358:1887–1898.
    OpenUrlCrossRefPubMed
  10. ↵
    1. JATOS Study Group
    . Principal results of the Japanese trial to assess optimal systolic blood pressure in elderly hypertensive patients (JATOS). Hypertens Res 2008; 31:2115–2127.
    OpenUrlCrossRefPubMed
  11. ↵
    1. Ogihara T,
    2. Saruta T,
    3. Rakugi H,
    4. et al
    5. Valsartan in Elderly Isolated Systolic Hypertension Study Group
    . Target blood pressure for treatment of isolated systolic hypertension in the elderly: Valsartan in Elderly Isolated Systolic Hypertension study. Hypertension 2010; 56:196–202.
    OpenUrlCrossRef
  12. ↵
    1. Liu L,
    2. Zhang Y,
    3. Liu G,
    4. Li W,
    5. Zhang X,
    6. Zanchetti A,
    7. FEVER Study Group
    . The Felodipine Event Reduction (FEVER) Study: a randomized long-term placebo-controlled trial in Chinese hypertensive patients. J Hypertens 2005; 23:2157–2172.
    OpenUrlCrossRefPubMed
  13. ↵
    1. ACCORD Study Group
    2. Cushman WC,
    3. Evans GW,
    4. Byington RP,
    5. et al
    . Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med 2010; 362:1575–1585.
    OpenUrlCrossRefPubMed
  14. ↵
    1. SPS3 Study Group
    2. Benavente OR,
    3. Coffey CS,
    4. Conwit R,
    5. et al
    . Blood-pressure targets in patients with recent lacunar stroke: the SPS3 randomised trial. Lancet 2013; 382:507–515.
    OpenUrlCrossRefPubMed
  15. ↵
    1. James PA,
    2. Oparil S,
    3. Carter BL,
    4. et al
    . 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014; 311:507–520. Erratum in: JAMA. 2014; 311:1809.
    OpenUrlCrossRefPubMed
  16. ↵
    1. Weber MA,
    2. Schiffrin EL,
    3. White WB,
    4. et al
    . Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich) 2014; 16:14–26.
    OpenUrlCrossRefPubMed
  17. ↵
    1. Ambrosius WT,
    2. Sink KM,
    3. Foy CG,
    4. et al
    5. SPRINT Study Research Group
    . The design and rationale of a multicenter clinical trial comparing two strategies for control of systolic blood pressure: the Systolic Blood Pressure Intervention Trial (SPRINT). Clin Trials 2014; 11:532–546.
    OpenUrlCrossRefPubMed
  18. ↵
    1. Myers MG,
    2. Godwin M,
    3. Dawes M,
    4. Kiss A,
    5. Tobe SW,
    6. Kaczorowski J
    . Conventional versus automated measurement of blood pressure in the office (CAMBO) trial. Fam Pract 2012; 29:376–382.
    OpenUrlCrossRefPubMed
  19. ↵
    1. Messerli FH,
    2. Mancia G,
    3. Conti CR,
    4. et al
    . Dogma disputed: can aggressively lowering blood pressure in hypertensive patients with coronary artery disease be dangerous? Ann Intern Med 2006; 144:884–893.
    OpenUrlCrossRefPubMed
  20. ↵
    1. Boutitie F,
    2. Gueyffier F,
    3. Pocock S,
    4. Fagard R,
    5. Boissel JP,
    6. INDANA Project Steering Committee; INdividual Data ANalysis of Antihypertensive intervention
    . J-shaped relationship between blood pressure and mortality in hypertensive patients: new insights from a meta-analysis of individual-patient data. Ann Intern Med 2002; 136:438–448.
    OpenUrlCrossRefPubMed
  21. ↵
    1. Mancia G
    . Effects of intensive blood pressure control in the management of patients with type 2 diabetes mellitus in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Circulation 2010; 122:847–849.
    OpenUrlFREE Full Text
  22. ↵
    1. Perkovic V,
    2. Rodgers A
    . Redefining blood-pressure targets—SPRINT starts the marathon. N Engl J Med 2015; 373:2175–2178.
    OpenUrlCrossRefPubMed
  23. ↵
    1. Margolis KL,
    2. O’Connor PJ,
    3. Morgan TM,
    4. et al
    . Outcomes of combined cardiovascular risk factor management strategies in type 2 diabetes: the ACCORD randomized trial. Diabetes Care 2014; 37:1721–1728.
    OpenUrlAbstract/FREE Full Text
  24. ↵
    1. Peterson JC,
    2. Adler S,
    3. Burkart JM,
    4. et al
    . Blood pressure control, proteinuria, and the progression of renal disease. The Modification of Diet in Renal Disease study. Ann Intern Med 1995; 123:754–762.
    OpenUrlCrossRefPubMed
  25. ↵
    1. Agodoa LY,
    2. Appel L,
    3. Bakris GL,
    4. et al
    5. African American Study of Kidney Disease and Hypertension (AASK) Study Group
    . Effect of ramipril vs amlodipine on renal outcomes in hypertensive nephrosclerosis: a randomized controlled trial. JAMA 2001; 285:2719–2728.
    OpenUrlCrossRefPubMed
  26. ↵
    1. Berl T,
    2. Hunsicker LG,
    3. Lewis JB,
    4. et al
    5. Collaborative Study Group
    . Impact of achieved blood pressure on cardiovascular outcomes in the Irbesartan Diabetic Nephropathy Trial. J Am Soc Nephrol 2005; 16:2170–2179.
    OpenUrlAbstract/FREE Full Text
  27. ↵
    1. Pohl MA,
    2. Blumenthal S,
    3. Cordonnier DJ,
    4. et al
    . Independent and additive impact of blood pressure control and angiotensin II receptor blockade on renal outcomes in the Irbesartan Diabetic Nephropathy Trial: clinical implications and limitations. J Am Soc Nephrol 2005; 16:3027–3037.
    OpenUrlAbstract/FREE Full Text
  28. ↵
    1. Bress AP,
    2. Tanner RM,
    3. Hess R,
    4. Colantonio LD,
    5. Shimbo D,
    6. Muntner P
    . Generalizability of results from the Systolic Blood Pressure Intervention Trial (SPRINT) to the US adult population. J Am Coll Cardiol 2015 Oct 31. doi:10.1016/j.jacc.2015.10.037. Epub ahead of print.
    OpenUrlCrossRef

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Cleveland Clinic Journal of Medicine: 83 (3)
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1 Mar 2016
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Interpreting SPRINT: How low should you go?
George Thomas, Joseph V. Nally, Marc A. Pohl
Cleveland Clinic Journal of Medicine Mar 2016, 83 (3) 187-195; DOI: 10.3949/ccjm.83a.15175

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Interpreting SPRINT: How low should you go?
George Thomas, Joseph V. Nally, Marc A. Pohl
Cleveland Clinic Journal of Medicine Mar 2016, 83 (3) 187-195; DOI: 10.3949/ccjm.83a.15175
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    • ABSTRACT
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