SYSTOLIC BLOOD PRESSURE INTERVENTION TRIAL: FINDINGS THAT IMPACT OLDER HYPERTENSIVE PATIENTS

摘要

Results from the Systolic Blood Pressure Intervention Trial (SPRINT) which compared usual (< 140 mm Hg) with intensive (< 120 mm Hg) SBP targets (ClinicalTrials.gov, ) demonstrated that a lower SBP target may be safely recommended for many older patients. SPRINT included 2636 community living subjects aged 75 and older (28% of the entire study population) who were assessed for frailty status including usual gait speed, cognitive function, orthostatic hypotension, and adverse events including injurious falls. In the group of older subjects randomized to the intensive arm there was a 34% reduction in the primary composite CVD outcome and a 33% reduction in all-cause mortality at 3.14 years of follow-up when the trial ended early (numbers needed to treat 27 and 41 respectively). These results did not differ for the most frail subgroup nor for those with impaired gait speed. While some adverse events were higher in the intensive group, there was no difference observed in serious adverse events including injurious falls. This symposium will provide additional SPRINT results of relevance to older hypertensive patients including: 1) predictors of adherence and retention; 2) results for the impact of intensive versus standard treatment goals on incident heart failure with and without reduced ejection fraction, 3) arterial stiffness as a predictor of SPRINT outcomes, and 4) results for the impact of intensive versus standard treatment goals on transitions in frailty status.