August 14, 2016

Intensive vs Standard Blood Pressure Control and Cardiovascular Disease Outcomes in Adults Aged ≥75Years: A Randomized Clinical Trial

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This is a  multicenter, randomized clinical trial of patients aged 75 years or older who participated in the Systolic Blood Pressure Intervention Trial (SPRINT) to determine the effects of intensive (<120 mm Hg) compared with standard (<140 mm Hg) SBP targets.

The primary cardiovascular disease outcome was a composite of nonfatal myocardial infarction, acute coronary syndrome not resulting in a myocardial infarction, nonfatal stroke, nonfatal acute decompensated heart failure, and death from cardiovascular causes. All-cause mortality was a secondary outcome. At a median follow-up of 3.14 years of the 2510 patients, there was a significantly lower rate of the primary composite outcome and all-cause mortality. The overall rate of serious adverse events (hypotension, electrolyte abnormalities, syncope, falls and AKI) was not different between treatment groups (48.4% in the intensive treatment group vs 48.3% in the standard treatment group; HR, 0.99 [95% CI, 0.89-1.11]). Based on this study, there may need to reevaluation of current recommendations regarding blood pressure targets in the elderly.


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