In the SPRINT trial (NEJM 2015), intensive blood pressure control to a systolic target <120 mmHg compared to standard target <140 mmHg in high-cardiovascular-risk (non-diabetic) adults showed which primary outcome?

• A No difference in cardiovascular events between the two groups
• B 25% relative risk reduction in the primary composite cardiovascular endpoint ✓
• C Intensive target increased stroke risk despite reducing MI
• D Intensive target reduced cardiovascular mortality but increased total mortality

Explanation

The SPRINT trial demonstrated a 25% relative risk reduction in the primary composite outcome (MI, ACS, stroke, HF, or CV death) in the intensive treatment group (SBP target <120 mmHg) compared to standard treatment (SBP <140 mmHg), with a number needed to treat of 61 over 3.26 years. All-cause mortality was also reduced by 27%. However, the intensive group had higher rates of adverse events including hypotension, syncope, and acute kidney injury. This trial led to revisions in hypertension guidelines supporting lower treatment targets in high-risk non-diabetic adults.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

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Written and medically reviewed by the StethoPrep medical team.