Hypertension Unit and Cardiorenal Translational Research Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre and CIBER in Cardiovascular (CIBERCV), Avenida de Córdoba s/n, 28041 Madrid, Spain.
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ and CIBER in Epidemiology and Public Health (CIBERESP), Arzobispo Morcillo 2, 28029 Madrid, Spain.
Nat Rev Cardiol. 2017 Sep;14(9):560-566. doi: 10.1038/nrcardio.2017.74. Epub 2017 May 11.
SPRINT is the first randomized, controlled trial showing that a systolic blood-pressure goal of <120 mmHg can be attained with cardiovascular benefits in a select group of patients with hypertension and an elevated cardiovascular risk with different origins. Although the patient population with characteristics like those in SPRINT makes up only 20-30% of the total hypertensive population, SPRINT is a landmark study that highlights the need to consider lower blood- pressure goals in the treatment of hypertension. Extending this study to include other patient populations and geographical areas is the next step for evaluating the benefits of strict blood-pressure targets and the generalizability of the SPRINT results. Importantly, the blood-pressure measurement method used in SPRINT differs from previous clinical trials, and raises the issue of whether a more accurate method should be used in clinical trials and if such method is feasible in clinical practice. This Perspectives article provides an analysis of the SPRINT data, focusing on patient characteristics, blood-pressure measurement method, and applicability of the SPRINT findings for future management guidelines.
SPRINT 是第一项随机对照试验,表明在具有不同起源的高血压和心血管风险升高的特定患者群体中,收缩压目标<120mmHg 可以实现心血管获益。尽管具有 SPRINT 特征的患者人群仅占高血压总人群的 20-30%,但 SPRINT 是一项具有里程碑意义的研究,强调需要考虑在高血压治疗中设定更低的血压目标。将这项研究扩展到包括其他患者人群和地理区域,是评估严格血压目标的益处和 SPRINT 结果的普遍性的下一步。重要的是,SPRINT 中使用的血压测量方法与以前的临床试验不同,这引发了一个问题,即是否应该在临床试验中使用更准确的方法,以及这种方法在临床实践中是否可行。本文观点对 SPRINT 数据进行了分析,重点关注患者特征、血压测量方法以及 SPRINT 研究结果对未来管理指南的适用性。