The SPRINT trial found that intensive blood pressure lowering to a target of less than 120 mm Hg significantly reduced the risk of major cardiovascular events like heart attack, stroke, and heart failure compared to standard treatment targeting under 140 mm Hg. Specifically, the primary outcome occurred in 1.65% per year in the intensive group versus 2.19% in the standard group. Intensive treatment also lowered the risks of cardiovascular and all-cause mortality. However, it increased the risk of hypotension and worsening renal function in patients without chronic kidney disease.

1. • Landmark trial; indicates that intensive BP lowering
to a target <120 mm Hg is superior to routine
management with a target of <140 mm Hg in non-
diabetic patients with HTN, including in elderly
patients. Reductions were also noted in CV and all-
cause mortality, accompanied by a reduction in CHF
• Likely to impact clinical practice and guidelines
Routine
management
(n = 4,683)
Intensive
control
(n = 4,678)
SPRINT
• Primary outcome, MI/ACS/stroke/CHF/CV death:
intensive vs. routine: 1.65%/year vs. 2.19%/year, HR
0.75, 95% CI 0.64-0.89; p < 0.0001; stroke: 1.3% vs.
1.5%, p = 0.5; CHF: 1.3% vs. 2.1%, p = 0.002
• Mortality: 3.3% vs. 4.5%, p = 0.0003; CV death: 0.8%
vs. 1.4%, p = 0.0005; worsening renal function among
patients without CKD: 3.8% vs. 1.1%, p < 0.001
• Hypotension: 2.4% vs. 1.4%, p = 0.001
Trial design: Patients with systolic BP ≥130 mm Hg and at least one risk factor were
randomized in a 1:1 fashion to either intensive SBP lowering (target <120 mm Hg) or
routine SBP management (target <140 mm Hg). Patients were followed for 5 years.
Results
Conclusions
SPRINT Research Group. N Engl J Med 2015;373:2103-16
Primary outcome
1.65
2.19
0
2.5
5
%/year
p < 0.0001