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A Randomized Trial of Intensive versus Standard Blood-Pressure Control

SPRINT randomized 9,361 adults at elevated cardiovascular risk (no diabetes) with systolic BP ≥130 mm Hg to intensive (<120 mm Hg) versus standard (<140 mm Hg) systolic targets; intensive treatment lowered fatal/nonfatal major cardiovascular events and all-cause mortality but increased selected serious adverse events.

Design

  • Population: 9,361 adults without diabetes, SBP ≥130 mm Hg, elevated CV risk
  • Arms: intensive systolic target <120 mm Hg vs standard <140 mm Hg (protocol-driven antihypertensive titration, not a feeding-study diet)
  • Primary composite: MI, other acute coronary syndromes, stroke, HF, or CV death
  • Median follow-up: 3.26 y (intervention stopped early for efficacy)

Headline outcomes (published primary ITT summary)

  • Primary composite rate: 1.65%/y (intensive) vs 2.19%/y (standard); HR 0.75 (95% CI 0.64–0.89; P < 0.001)
  • All-cause mortality: HR 0.73 (95% CI 0.60–0.90; P = 0.003)
  • Serious adverse events: higher rates of hypotension, syncope, electrolyte abnormalities, AKI on intensive therapy; not higher for injurious falls

Evidence hygiene

  • Not a diet trial—pair with DASH / sodium factorial feeding studies for food-pattern physiology, not interchangeable effect sizes.
  • Generalisability: trial BP measurement protocol and treatment intensity differ from usual community care—read discussion and erratum thread on PubMed.

Publication

SPRINT Research Group; Wright JT Jr, Williamson JD, et al. N Engl J Med. 2015 Nov 26;373(22):2103–2116. PMID 26551272.

Outcomes

  • All-Cause Mortality Risk
    Events: /
  • All-Cause Mortality Rate
    Events: /
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