'The Lower the Better' Association between White-coat Effect-excluded Blood Pressure and Cardiovascular Events in High-risk Hypertension: Insights from SPRINT

摘要

The results of a landmark randomized control investigation - the Systolic Blood Pressure Intervention Trial (SPRINT) concerning the target blood pressure (BP) level in high-risk hypertensive patients - have been published. The SPRINT study was ended in light of its clear findings demonstrating that strict office systolic BP control at <120 mmHg was superior to 'usual' systolic BP control at < 140 mmHg for preventing cardiovascular events including heart failure and mortality in elderly hypertensive patients (>75 years old) and high-risk patients with a high Framingham risk score, a history of cardiovascular disease (except stroke), or chronic kidney disease [1]. The SPRINT results were unexpected, as recently published international and Japanese guidelines for the management of hypertension guidelines all increased the threshold of target office systolic BP from 140 mmHg to 150 mmHg for elderly hypertensive patients.