The SPRINT trial compared intensive (systolic BP target < 120 mmHg) versus standard (systolic BP target < 140 mmHg) BP control in non-diabetic adults at high cardiovascular risk. Its primary finding and the primary concern with intensive therapy were:
- A Intensive control did not reduce CV events; the only concern was cost
- B Intensive control reduced CV events and all-cause mortality but increased rates of hypotension, syncope, AKI, and electrolyte abnormalities ✓
- C Intensive control increased CV mortality by causing coronary hypoperfusion (J-curve phenomenon)
- D Intensive control only benefited patients with diabetes
Explanation
The SPRINT trial (9361 non-diabetic adults, 2015) demonstrated that intensive systolic BP control (< 120 mmHg) compared to standard (< 140 mmHg) significantly reduced the primary composite endpoint of major adverse cardiovascular events (25% relative risk reduction) and all-cause mortality (27% reduction). The trial was stopped early for benefit. However, intensive therapy significantly increased adverse events: hypotension (2.4× more common), syncope, acute kidney injury (AKI — 3.2% vs 1.8%), and hypokalaemia. These safety concerns inform individualised treatment decisions, particularly in the elderly.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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Written and medically reviewed by the StethoPrep medical team.