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The full results of the SPRINT study which we reported on in the winter edition of Positive Pressure have now been published.
The SPRINT (Systolic Blood Pressure Intervention Trial) study demonstrates that lowering systolic blood pressure to a lower target of 120mm Hg reduces the number of strokes, heart attacks and heart failure, compared to a group controlled to the conventional level of 140mm Hg. The study also showed that lowering blood pressure to 120mm Hg resulted in a reduction in total mortality of 30%.
The blood pressure intervention portion of the trial was stopped early as a result of such successful study findings, which showed a 25% reduction in the primary cardiovascular outcome and a 27% reduction of all-cause mortality in patients randomized to the lower 120mm Hg systolic blood pressure target. In these patients, a 38% reduction in heart failure and 43% reduction in death from heart-related events was seen.
Whilst treating raised blood pressure is known to reduce the risk of stroke, heart attacks and death, there has been controversy about the target blood pressure to aim for in people receiving treatment. In addition there were concerns that reducing blood pressure too low might be harmful. Currently the recommended target is 140/90mm Hg. In the UK approximately only 40% of people being treated for high blood pressure are controlled to this level.
Professor Graham MacGregor, chairman of Blood Pressure UK said: “This study is tremendous news for patients with high blood pressure as it shows that lowering blood pressure below conventional targets can cause further reductions in cardiovascular events, e.g. strokes, heart attacks and heart failure, and also reduce total mortality. The study is clearly going to have a major impact on the way that we manage high blood pressure in the UK.”
The SPRINT study is a large, very well controlled randomised study and demonstrates unequivocally that the target blood pressure in patients who are on treatment and who have one additional cardiovascular risk factor should be 120mm Hg. These findings will revolutionise the treatment of high blood pressure. To achieve this target, more than one treatment will be required, in particular drugs in triple generic combinations, most of which are not available in the UK. There are also major implications for GP practices as high blood pressure is one of the commonest reasons to be seen in General Practice.
Here are the full results of the Sprint study.