The trial of SPRINT: A breakthrough in the treatment of high blood pressure

There are few medical advances that deserve an immediate change in practice, but the SPRINT trial seems to be one of the studies. In a recent press release, the SPRINT researchers announced the results of their study showed aiming for a systolic blood pressure (the top number) of 120 mmHg was superior to a target of 140 mm Hg. 

This change reduces the risk of death by almost 25% and reduced the rate of cardiovascular problems as a whole, including heart attacks, strokes and heart failure by almost a third - welcome news to every doctor and patient.

SPRINT trial was a randomized clinical trial followed more than 9,000 US for several years. All study participants were aged 50 or ages, had high blood pressure or were at higher risk of heart disease or have had kidney disease. Half the participants were given a target blood pressure of 120 mmHg and the other half were given a target of 140 mm Hg. On average 120 mm Hg group needs three drugs for high blood pressure to achieve this, and the group needed 2 140 mm Hg.

This study was primarily funded by the National Heart, Lung and Blood Institute of the National Institutes of Health. This test is a wonderful example of the nature of long-term, large-scale clinical trials are needed to advance the care of patients significantly.  

The study results also show the importance of randomized clinical trials - that is, studies in which patients are randomly assigned to one of two treatment arms. Finally, the credit must be given to participants who have agreed to be included in the study. They generously and selflessly contributed to the advancement of medical science and the improvement of patient care worldwide. Ultimately, they also helped to improve their own care.

Although the results are very exciting, it will be important to see the details in the full text of the study, which has not yet been published. Sometimes an article provides more subtle interpretations of the findings that initial press release. The usual caveats notwithstanding, these results appear to be a major discovery with immediate applicability.

It usually takes years before the effects of high blood pressure (at least in the range studied in this trial) cause serious cardiovascular problems. Therefore, for people with high blood pressure reasonably well controlled, no need to rush to see your doctor immediately.

However, even if you think your well controlled under current rules, blood pressure would be interesting to discuss with your doctor if a goal of lowering blood pressure would be in order. Sure, you and your doctor have to balance the benefits observed in the SPRINT trial against the potential risks of taking additional medication for blood pressure and possible side effects.  

The risk of side effects may be increased in certain patient groups, such as seniors who take multiple types of drugs. However, the availability of several generic drugs for blood pressure should lead to these results are applied in the vast majority of people with high blood pressure.
By: Deepak Bhatt, MD,MPH.