Department of Preventive Medicine, University of Tennessee Health Science Center, and Medical Service, Veterans Affairs Medical Center, Memphis (W.C.C.).
Department of Veterans Affairs Cooperative Studies Program Clinical Research Pharmacy Coordinating Center, Albuquerque, NM (R.J.R.).
Hypertension. 2022 Sep;79(9):2071-2080. doi: 10.1161/HYPERTENSIONAHA.121.17233. Epub 2022 Jun 29.
The SPRINT (Systolic Blood Pressure Intervention Trial) demonstrated reductions in major cardiovascular disease events and mortality with an intensive systolic blood pressure (SBP) goal intervention. However, a detailed description of the blood pressure intervention, antihypertensive medication usage, blood pressure levels, and rates and predictors of blood pressure control has not been reported previously.
Hypertensive participants (n=9361) 50 years and older with elevated cardiovascular disease risk were randomized 1:1 to SBP goal <120 mm Hg or SBP goal <140 mm Hg. Guideline-recommended antihypertensive medications and dosing were provided at no cost. Intensive group participants were started on at least 2 medications, and medications were adjusted monthly until SBP goal was achieved, if feasible. Standard group participants were treated to achieve SBP 135 to 139 mm Hg.
Baseline blood pressure (median±interquartile range) was 138±19/78±16 mm Hg. For intensive group participants, percent at goal rose from 8.9% at baseline to 52.4% at 6 months and average antihypertensive medications rose from 2.2 to 2.7; SBP was <120 mm Hg in 61.6% and <130 mm Hg in 80.0% at their final visit. For the standard group participants, percent at goal rose from 53.0% at baseline to 68.6% at 6 months, while antihypertensive medications fell from 1.9 to 1.8. From 6 to 36 months, median SBP was stable at 119±14 mm Hg for intensive and 136±15 mm Hg for standard participants, with stable numbers of medications. Few predictors of SBP control were found in multiple regression models.
These results may inform and help replicate the benefits of SPRINT in clinical practice.
URL: http://www.
gov; Unique identifier: NCT01206062.
SPRINT（收缩压干预试验）表明，强化收缩压（SBP）目标干预可降低主要心血管疾病事件和死亡率。然而，以前尚未详细描述血压干预、降压药物使用、血压水平以及血压控制率和预测因素。
将 50 岁及以上心血管疾病风险升高的高血压参与者随机分为 1:1 组，分别接受 SBP 目标<120mmHg 或 SBP 目标<140mmHg。免费提供指南推荐的降压药物和剂量。强化组参与者至少开始使用 2 种药物，每月调整药物剂量，直到达到 SBP 目标，如果可行的话。标准组参与者接受治疗，以实现 SBP 135-139mmHg。
基线血压（中位数±四分位距）为 138±19/78±16mmHg。对于强化组参与者，目标达标率从基线时的 8.9%上升到 6 个月时的 52.4%，平均降压药物从 2.2 增加到 2.7；最终就诊时，61.6%的患者 SBP<120mmHg，80.0%的患者 SBP<130mmHg。对于标准组参与者，目标达标率从基线时的 53.0%上升到 6 个月时的 68.6%，同时降压药物从 1.9 降至 1.8。从 6 个月到 36 个月，强化组的中位数 SBP 稳定在 119±14mmHg，标准组稳定在 136±15mmHg，药物数量稳定。在多变量回归模型中，发现了几个血压控制的预测因素。
这些结果可能为在临床实践中复制 SPRINT 的益处提供信息和帮助。
网址：http://www.。
gov；唯一标识符：NCT01206062。
