Researchers released results this week for a landmark National Institutes of Health study that calls for doctors to more intensively manage hypertension for adults over 50, aiming for blood pressure targets well below current guidelines.
Tulane University epidemiology professor Dr. Paul K. Whelton presented the highly anticipated results for the Systolic Blood Pressure Intervention Trial (SPRINT) at the American Heart Association (AHA) Scientific Sessions in Orlando, Florida, as they were published online in the New England Journal of Medicine. Dr. Whelton is chair of the study’s national steering committee.
The study found that adjusting medication to achieve systolic pressure of 120 mm Hg instead of the current recommendation of 140 mm Hg significantly reduced rates of cardiovascular disease in adults 50 years and older with high blood pressure. The lower blood pressure target reduced rates of cardiovascular events, such as heart attack, heart failure and stroke, by 25 percent and reduced risk of death by 27 percent.
The results were so striking that NIH stopped the study in August — a year earlier than planned— and released preliminary findings in September. The study included more than 9,300 participants at 100 trial sites, including Tulane University.
Approximately 28 percent of participants were 75 or older and 28 percent had chronic kidney disease. Hospitalizations associated with reports of low blood pressure, fainting, electrolyte abnormalities and acute kidney damage were more common in the intensive target group. However, other serious adverse events associated with lower blood pressure, such as slow heart rate and falls with injuries, did not increase in the intensive group. In patients with chronic kidney disease, there was no difference in decline in kidney function between the two groups.
“The benefits of more intensive blood pressure lowering exceeded the potential for harm, regardless of gender or race/ethnicity,” says Dr. Whelton, who is also chair of the American College of Cardiology/American Heart Association Hypertension Guidelines Committee.
Dr. Whelton says the committee will meet to consider the implications of the study.