Will the Systolic Blood Pressure Intervention Trial (SPRINT) change Treatment Targets in Hypertension?

Abstract

Most of the current guidelines recommend a target systolic blood pressure (SBP) of <140 mmHg when treating hypertension. However, in the recent systolic blood pressure intervention trial (SPRINT) study which compared targets of 140 and 120 mmHg in patients at high cardiovascular risk and concluded that there were greater cardiovascular (CV) and mortality benefits at the lower target, including those patients aged above 75 years. The blood pressure (BP) measurement method in SPRINT was unconventional and the achieved SBP in the intensively treated patients corresponds to pressure in an orifice valve of about 130 mmHg. Importantly, SPRINT excluded patients with diabetes or at low CV risk. These patients should be treated to <140 mmHg since CV events may increase at more aggressive targets. In communities with limited resources it is often not possible to evaluate CV risk and <140 mmHg should be the usual target; indeed, in Stage 1 hypertension, drug therapy can be delayed while lifestyle changes are tried.