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BP Targets in Hypertension: What Should We Do Now That SPRINT Is Out?

  • Hypertension (AJ Peixoto and DS Geller, Section Editors)
  • Published:
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Abstract

Systolic blood pressure (SBP) is an important predictor of cardiovascular disease (CVD) outcomes. Lowering SBP has been shown to reduce CVD morbidity and mortality, but the optimal SBP target continues to be a topic of intense debate. The Systolic Blood Pressure Intervention Trial (SPRINT) reported a significantly lower risk for CVD outcomes and all-cause mortality by targeting SBP <120 mmHg compared with <140 mmHg in a population of hypertensive persons at high CV risk. In this review, we discuss the strengths, limitations, and generalizability of SPRINT findings to other hypertensive populations that were excluded from the trial, including those with diabetes or prior stroke, <50 years old, and at lower CVD risk. We will focus on the implications of SPRINT findings for appropriate BP targets in high-risk groups of hypertensive persons, including the elderly and those with chronic kidney disease (CKD). We will also address the cost-effectiveness of intensive BP treatment as implemented in SPRINT and the implications of SPRINT for health care policy and future BP guidelines.

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Authors and Affiliations

  1. Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA

    Hemal Bhatt, Lama Ghazi, David Calhoun & Suzanne Oparil

Authors
  1. Hemal Bhatt
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  2. Lama Ghazi
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  3. David Calhoun
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  4. Suzanne Oparil
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Corresponding author

Correspondence to Suzanne Oparil.

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Conflict of Interest

Hemal Bhatt, Lama Ghazi and David Calhoun report no conflict of interest.

Suzanne Oparil reports grant/personal fees/non-financial support from NHLBI, Forest Laboratories, Amgen (Onyx–Subsidiary), AstraZeneca, Bayer Healthcare Pharmaceuticals, Inc., Boehringer-Ingelheim, GlaxoSmithKline, Merck and Co., Novartis, Arbor Pharmaceuticals LLC, and Medtronic. She is co-chair of JNC 8 committee and participated in the previous JNC guidelines writing committees. She is a writing group member of the World Heart Federation (WHF), European Society of Hypertension (ESH), and European Public Health Association (EPH) Global Working Group on Optimal Salt Consumption and Cardiovascular Health. She is also a co-author on a manuscript on Renal safety study that is in development for Takeda Global Research & Development.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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The views expressed in this article are those of the authors and do not necessarily represent the official position of the National Institutes of Health (NIH), the Department of Veterans Affairs, the U.S. Government, or the SPRINT Research Group.

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This article is part of the Topical Collection on Hypertension

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Bhatt, H., Ghazi, L., Calhoun, D. et al. BP Targets in Hypertension: What Should We Do Now That SPRINT Is Out?. Curr Cardiol Rep 18, 98 (2016). https://doi.org/10.1007/s11886-016-0775-0

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