Results At 1 year, the mean systolic blood pressure was 121.4 mm Hg in the intensive-treatment group and 136.2 mm Hg in the standard-treatment group. The intervention was stopped early after a median follow-up of 3.26 years owing to a significantly lower rate of the primary composite outcome in the intensive-treatment group than in the standard-treatment group (1.65% per year vs. 2.19% per year; hazard ratio with intensive treatment, 0.75; 95% confidence interval [CI], 0.64 to 0.89; P.

Hypertension is highly prevalent in the adult population in the United States, especially among persons older than 60 years of age, and affects approximately 1 billion adults worldwide. Among persons 50 years of age or older, isolated systolic hypertension is the most common form of hypertension, and systolic blood pressure becomes more important than diastolic blood pressure as an independent risk predictor for coronary events, stroke, heart failure, and end-stage renal disease (ESRD). The Global Burden of Disease Study identified elevated blood pressure as the leading risk factor, among 67 studied, for death and disability-adjusted life-years lost during 2010. Clinical trials have shown that treatment of hypertension reduces the risk of cardiovascular disease outcomes, including incident stroke (by 35 to 40%), myocardial infarction (by 15 to 25%), and heart failure (by up to 64%). However, the target for systolic blood-pressure lowering is uncertain. Observational studies have shown a progressive increase in cardiovascular risk as systolic blood pressure rises above 115 mm Hg, but the available evidence from randomized, controlled trials in the general population of patients with hypertension only documents the benefit of treatment to achieve a systolic blood-pressure target of less than 150 mm Hg, with limited data concerning lower blood-pressure targets.

In a trial involving patients with type 2 diabetes mellitus, the rate of major cardiovascular events was similar with a systolic blood-pressure target of less than 120 mm Hg and the commonly recommended target of less than 140 mm Hg, though the rate of stroke was lower with the target of less than 120 mm Hg. A recent trial involving patients who had had a stroke compared treatment to lower systolic blood pressure to less than 130 mm Hg with treatment to lower it to less than 150 mm Hg and showed no significant benefit of the lower target with respect to the overall risk of another stroke but a significant benefit with respect to the risk of hemorrhagic stroke. The hypothesis that a lower systolic blood-pressure goal (e.g. Study Design and Oversight SPRINT was a randomized, controlled, open-label trial that was conducted at 102 clinical sites (organized into 5 clinical center networks) in the United States, including Puerto Rico (see the, available with the full text of this article at NEJM.org).

A trial coordinating center served as a data and biostatistical core center and supervised the central laboratory, the electrocardiography reading center, the magnetic resonance imaging reading center, and the drug-distribution center. The rationale and protocol for the trial are publicly available, and the is available at NEJM.org.

Download Modio 3 Game Tuts Download more. SPRINT was sponsored by the NHLBI, with cosponsorship by the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and the National Institute on Aging. An independent data and safety monitoring board monitored unblinded trial results and safety events. The study was approved by the institutional review board at each participating study site.

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Ub Funkeys Install Problems more. The steering committee designed the study, gathered the data (in collaboration with investigators at the clinics and other study units), made the decision to submit the manuscript for publication, and vouches for the fidelity of the study to the. The writing committee wrote the manuscript and vouches for the completeness and accuracy of the data and analysis. The coordinating center was responsible for analyzing the data. Scientists at the National Institutes of Health participated in the design of the study and as a group had one vote on the steering committee of the trial. Study Population Participants were required to meet all the following criteria: an age of at least 50 years, a systolic blood pressure of 130 to 180 mm Hg (see the ), and an increased risk of cardiovascular events. Increased cardiovascular risk was defined by one or more of the following: clinical or subclinical cardiovascular disease other than stroke; chronic kidney disease, excluding polycystic kidney disease, with an estimated glomerular filtration rate (eGFR) of 20 to less than 60 ml per minute per 1.73 m 2 of body-surface area, calculated with the use of the four-variable Modification of Diet in Renal Disease equation; a 10-year risk of cardiovascular disease of 15% or greater on the basis of the Framingham risk score; or an age of 75 years or older. Patients with diabetes mellitus or prior stroke were excluded.