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Has the SPRINT trial introduced a new blood-pressure goal in hypertension?

Nature Reviews Cardiology volume 14, pages 560–565 (2017)Cite this article

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Abstract

SPRINT is the first randomized, controlled trial showing that a systolic blood-pressure goal of <120 mmHg can be attained with cardiovascular benefits in a select group of patients with hypertension and an elevated cardiovascular risk with different origins. Although the patient population with characteristics like those in SPRINT makes up only 20–30% of the total hypertensive population, SPRINT is a landmark study that highlights the need to consider lower blood- pressure goals in the treatment of hypertension. Extending this study to include other patient populations and geographical areas is the next step for evaluating the benefits of strict blood-pressure targets and the generalizability of the SPRINT results. Importantly, the blood-pressure measurement method used in SPRINT differs from previous clinical trials, and raises the issue of whether a more accurate method should be used in clinical trials and if such method is feasible in clinical practice. This Perspectives article provides an analysis of the SPRINT data, focusing on patient characteristics, blood-pressure measurement method, and applicability of the SPRINT findings for future management guidelines.

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Figure 1: Potential influence of the SPRINT trial in blood-pressure goals in daily clinical practice.

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Acknowledgements

Specific funding for this study was obtained from FIS ISCIII grants PI13/02321, PI16/01460, PIE13/00045, PI14/01841, CP15/0129, CIBERCV, Fundación SENEFRO/SEN, and Fondo Europeo de Desarrollo Regional FEDER and FSE.

Author information

Authors and Affiliations

  1. Gema Ruiz-Hurtado is at the Hypertension Unit and Cardiorenal Translational Research Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre and CIBER in Cardiovascular (CIBERCV), Avenida de Córdoba s/n, 28041 Madrid, Spain.,

    Gema Ruiz-Hurtado

  2. José R. Banegas is at the Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ and CIBER in Epidemiology and Public Health (CIBERESP), Arzobispo Morcillo 2, 28029 Madrid, Spain.,

    José R. Banegas

  3. Pantelis A. Sarafidis is at the Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Konstantinoupoleos 49, 54642, Greece.,

    Pantelis A. Sarafidis

  4. Massimo Volpe is at the Cardiology Department of Clinical and Molecular Medicine, Sapienza University, Viale Regina Elena 324, 00161 Rome; and at IRCCS Neuromed, Via Atinense 18, 86077 Pozzilli IS, Italy.,

    Massimo Volpe

  5. and at IRCCS Neuromed, Via Atinense 18, 86077 Pozzilli IS, Italy.,

    Massimo Volpe

  6. Bryan Williams is at University College London, Institute of Cardiovascular Science and NIHR UCL Hospitals Biomedical Research Centre, Maple House, First Floor Suite A, 149, Tottenham Court Road, London W1T 7DN, UK.,

    Bryan Williams

  7. Spain; at the Department of Preventive Medicine and Public Health, Luis M. Ruilope is at the Hypertension Unit and Cardiorenal Translational Research Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre and CIBER in Cardiovascular (CIBERCV), Avenida de Córdoba s/n, 28041 Madrid, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ and CIBER in Epidemiology and Public Health (CIBERESP), Arzobispo Morcillo 2, 28029 Madrid, Spain; and at the School of Doctoral Studies and Research, Universidad Europea de Madrid, Tajo s/n, 28670, Madrid, Spain.,

    Luis M. Ruilope

  8. at the Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ and CIBER in Epidemiology and Public Health (CIBERESP), Arzobispo Morcillo 2, 28029 Madrid, Spain,

    Luis M. Ruilope

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  1. Gema Ruiz-Hurtado
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Contributions

G.R.-H., J.R.B., and L.M.R. researched data for the article and wrote the manuscript. All authors provided substantial contribution to the discussion of content and reviewed and/or edited the manuscript before submission.

Corresponding author

Correspondence to Luis M. Ruilope.

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Ruiz-Hurtado, G., Banegas, J., Sarafidis, P. et al. Has the SPRINT trial introduced a new blood-pressure goal in hypertension?. Nat Rev Cardiol 14, 560–565 (2017). https://doi.org/10.1038/nrcardio.2017.74

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