New data supports a lower blood pressure target
Additional data for 2016’s landmark SPRINT trial shows a blood pressure target of 120mmHg rather than 140mmHg prevents more heart attacks and strokes
Back in 2016, The SPRINT Trial was the first major study to show that lowering blood pressure to 120mmHg rather than the usual target of 140/90mmHg further reduced the risk of strokes, heart attacks and other serious diseases. The study was stopped early because the more intensive treatment was clearly more effective. A new paper has now been published to include data collected in the months after the trial was stopped, and the analysis supports the initial conclusions.
The Systolic Blood Pressure Intervention Trial (SPRINT) Trial included 9361 people aged 50+ with high blood pressure and at least one other risk factor for diseases of the heart and blood vessels. It was designed to see whether intensive treatment to lower blood pressure to 120mmHg systolic (the top number) saved more lives than the usual target of 140mmHg. The main outcomes measured were heart attack, other serious heart conditions, stroke, heart failure, and death from diseases of the heart and blood vessels.
The original analysis included 3.33 years of follow up and showed that the intensive treatment significantly lowered the risk of serious illness. The group receiving intensive treatment had a rate of serious outcomes of 1.77% per year compared 2.4% in the group receiving normal treatment, and the death rate was 1.06% per year compared to 1.41%. There were, however, more side effects in the intensive-treatment group including hypotension (low blood pressure), electrolyte abnormalities, kidney problems, and fainting.
When the trial ended, those taking part were referred back to their GP and were free to change or continue their blood pressure medicines and treatment goals.
The original analysis included results collected up until the trial ended in August 2015, and the new paper published in May 2021 includes an analysis of data through July 29, 2016, including data from post-trial visits.
When the follow-up data was added (3.88 years in total) similar results were found, supporting the original findings. The only exception was in heart failure where the protective effect was lost, which the authors hypothesis could be due to changes in medicines or a chance finding, and was based on only a small number of cases.
The new results add weight to the orginal finding that a lower target blood pressure of 120mmHg resulted in lower rates of major illness than 140mmHg, both during the trial and in the months afterwards.
Professor Graham MacGregor, Chairman of Blood Pressure UK, says: “The SPRINT Trial was a landmark trial in demonstrating the lives that can be saved with a lower blood pressure target. The new analysis supports these findings and is a strong case for intensive treatment. This gives more information to health professionals in reviewing medicines to achieve optimal blood pressure control while managing the risk of side effects.”
Read the study in the New England Journal of Medicine