SPRINT study: far lower systolic blood pressure
Authors:
prof. CSc. Mudr Miroslav Souček; MUDr. Ph.D. Ivan Řiháček; MUDr. Jan Novák
Authors‘ workplace:
II. interní klinika LF MU a FN u sv. Anny v Brně: Pekařská 53, 656 91 Brno
Published in:
Čas. Lék. čes. 2016; 155: 175-178
Category:
Review Article
Overview
There is still no consensus, which blood pressure value is the most profitable for the patients when treating the systolic hypertension in the context of reduction of cardiovascular events and cardiovascular and overall mortality.
Researchers of the ACCORD study were comparing intensive treatment of systolic blood pressure bellow 120 mmHg and standard treatment reaching bellow 140 mmHg and showed no influence of intensive treatment on the primary goal in individuals with diabetes mellitus.
Last autumn, SPRINT study was presented and published showing the favourable effect of intensive (i. e. bellow 120 mmHg) blood pressure lowering on combined primary goal which was myocardial infarction, other acute coronary syndromes, ischemic stroke, heart failure or death from cardiovascular reasons. On the other hand, intensive treatment also resulted in statistically significant occurrence of adverse events (hypotension, syncope, renal injury of failure).
Keywords:
systolic blood pressure, target values, cardiovascular events, hypotension
Sources
1. Franklin SS, Jacobs MJ, Wong ND et al. Predominance of isolated systolic hypertension among middle-aged and elderly US hypertensives: analysis based on National Health and Nutrition Examination Survey (NHANES) III. Hypertension 2001; 37: 869–874.
2. Chobanian AV, Bakris GL, Black HR et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 Report. JAMA 2003; 289: 2560–2572.
3. Hsu CY, McCulloch CE, Darbinian J et al. Elevated blood pressure and risk of end-stage renal disease in subjects without baseline kidney disease. Arch Intern Med 2005; 165: 923–928.
4. Sundström J, Arima H, Jackson R et al. Effects of blood pressure reduction in mild hypertension: a systematic review and meta-analysis. Ann Intern Med 2015; 162: 184–191.
5. Neal B, MacMahon S, Chapman N. Effects of ACE inhibitors, calcium antagonists, and other blood pressure – lowering drugs: results of prospectively designed overview of randomised trials. Lancet 2000; 356: 1955–1964.
6. Psaty BM, Smith NL, Siscovick DS et al. Health outcomes associated with antihypertensive therapies used as first-line agents: systematic review and meta-analysis. JAMA 1997; 277: 739–745.
7. Lewington S, Clarke R, Qizilbash N et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: 1903–1913.
8. Beckett NS, Peters R, Fletcher AE et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med 2008; 358: 1887–1898.
9. Verdecchia P, Staessen JA, Angeli F et al. Usual versus tight control of systolic blood pressure in non-diabetic patients with hypertension (Cardio.Sis): a open-label randomised trial. Lancet 2009; 374: 525–533.
10. Cushman WC, Evans GW, Byington RP et al.; ACCORD Study Group. Effect of intensive blood pressure control in type 2 diabetes mellitus. N Engl J Med 2010; 373: 2180–2182.
11. Benavente OR, Coffey CS, Conwit R et al. Blood-pressure targets in pacients with recent lacunar stroke: the SPS3 randomised trial. Lancet 2013; 382: 507–515.
12. Wright JT, Williamson PK, Snyder JK et al.; The SPRINT Group. A randomised trial of intensive versus standard blood-pressure control. N Engl J Med 2015; 373: 2103–2116.
13. Perkovic v, Rodgers A. Redefining blood-pressure targets – SPRINT starts the marathon. N Engl J Med 2015; 373: 2175–2178.
14. Drazen JM, Morrissey S, Campion EW, Jarcho JA. A SPRINT to the finish. N Engl J Med 2015; 373: 2174–2175.
15. Cushman WC, Evans GW, Byington RP et al.; ACCORD Study Group. Effect of intensive blood pressure control in type 2 diabetes mellitus. N Engl J Med 2010; 373: 2180–2182.
16. Filipovský J, Widimský J, Ceral J et al. Diagnostické a léčebné postupy u arteriální hypertenze – verze 2012. Hypertenze a kardiovaskulární prevence 2013; 3: 1–15.
17. Souček M, Widimský J, Lánská V. Control of hypertension in patients with hypertension, diabetes a impaired fasting glucose by Czech primary care physicians. Kidney Blood Press Res 2006; 29: 366–372.
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Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain managementArticle was published in
Journal of Czech Physicians
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