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Groundbreaking heart study may change guidelines for treating high blood pressure

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Jennifer Johnson McEwen

According to the initial results of a major National Institutes of Health (NIH) clinical trial, more intensive management of high blood pressure may help significantly reduce rates of cardiovascular disease and lower the risk of death among older adults.

The landmark study, called the Systolic Blood Pressure Intervention Trial (SPRINT), began in 2009 and recruited approximately 9,300 male and female participants from medical centers and clinical practices throughout the United States and Puerto Rico, including Emory University.

The goal of SPRINT was to determine the potential benefits of reducing systolic blood pressure to less than 120 millimeters of mercury (mm Hg) for hypertensive adults 50 years and older who are at risk for developing heart disease or kidney disease. Well-established clinical guidelines recommended a systolic blood pressure of less than 140 mm Hg for healthy adults and 130 mm Hg for adults with kidney disease or diabetes.

The SPRINT participants were randomly assigned to one of two groups that differed according to targeted levels of blood pressure control. The standard group received an average of two different blood pressure medications to achieve a target of less than 140 mm Hg. The intensive treatment group received an average of three medications to achieve a target of less than 120 mm Hg.

Researchers found that adjusting the amount or type of blood pressure medication to achieve a target systolic pressure of 120 mm Hg resulted in reduced rates of cardiovascular events, such as heart attack and heart failure — as well as stroke — by almost a third and the risk of death by almost a quarter, as compared to the target systolic pressure of 140 mm Hg.

NIH officials say they stopped the SPRINT study earlier than originally planned in order to quickly disseminate the significant preliminary results calling it "potentially lifesaving information" that will be useful to health care providers as they consider the best treatment options for their patients.

"The preliminary findings from the SPRINT trial are impressive and are likely to have a significant impact on medical practice as well as future guidelines," says Emory Heart & Vascular Center cardiologist Laurence Sperling, MD.

"Evidence that a lower systolic blood pressure target (120 mm Hg) in the population studied reduces major cardiovascular events and death will be critically valuable for the field of cardiovascular prevention."

Sperling is currently serving as president of the American Society for Preventive Cardiology. He is the medical director of preventive cardiology at Emory Healthcare and professor of medicine at Emory University School of Medicine.

For more information on the SPRINT findings, please visit the NIH news release.

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