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         A large study funded by the National Institutes of Health (NIH) has found that a more intensive strategy of lowering blood pressure—one that aims to achieve a systolic blood-pressure target of 120 mm Hg—reduces the risk of death and cardiovascular events when compared with a strategy that lowers systolic blood pressure to conventional targets.

In the Systolic Blood Pressure Intervention Trial (SPRINT), investigators report that treating high-risk hypertensive adults 50 years of age and older to a target of 120 mm Hg significantly reduced cardiovascular events by 30% and reduced all-cause mortality by nearly 25% when compared with patients treated to a target of 140 mm Hg.SPRINT investigators excluded patients with diabetes and those with a history of stroke. Approximately 25% of patients in the study were 75 years of age and older.

The study, which included hypertensive patients with one additional cardiovascular risk factor or preexisting kidney disease, was stopped earlier than the planned 2018 completion date, given the benefit of the intensive strategy, according to investigators. In SPRINT, conducted across 100 clinical centers in the US and Puerto Rico, approximately 9300 patients were randomized to two treatment strategies.

The inclusion criteria for entry in SPRINT would apply to a vast majority of  US patients with  hypertension, which will make the impressive results useful to physicians in practice. SPRINT investigators  hope that, unlike for the JNC 8, it will not take more than decade for a JNC 9 to digest these seminal findings before providing US physicians with evidence-based and clinically useful recommendations.

http://www.medscape.com/viewarticle/850866