title: Applying the Systolic Blood Pressure Intervention Trial Results to Older Adults.
abstract: The Systolic Blood Pressure Intervention Trial (SPRINT; ClinicalTrials.gov, NCT01206062) was stopped early because of significantly lower risk of cardiovascular disease in participants randomized to a systolic blood pressure target of 120 mmHg (intensive) than in those randomized to 140 mmHg (standard). The cardiovascular outcome benefit was also identified in subjects aged 75 and older assigned to the intensive arm-34% lower than in the standard arm-in addition to 33% lower all-cause mortality at 3.14 years of follow-up. These beneficial outcomes held in older participants characterized as frail or with impaired gait speed. This article addresses several questions that need to be considered in applying the SPRINT results to the clinical care of older adults: Why are the SPRINT results discordant from those of epidemiological studies? Do the SPRINT findings generalize to the frail, older adults that I care for? Were there more adverse events in the intensive treatment group? What about cognitive and kidney outcomes? What are future considerations, and how low should we go?
authors.affiliation: Division of Geriatrics, School of Medicine, University of Utah, Salt Lake City, Utah.|Geriatric Research, Education, and Clinical Center, Veterans Affairs Salt Lake City, Salt Lake City, Utah.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Supiano
authors.affiliation: Section on Geriatric Medicine, Department of Internal Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
authors.forename: Jeff D
authors.initials: JD
authors.lastname: Williamson
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001795:Blood Pressure Determination; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002423:Cause of Death; D019468:Disease Management; D057239:Early Termination of Clinical Trials; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007024:Hypotension, Orthostatic; D055118:Medication Adherence; D016032:Randomized Controlled Trials as Topic
chemical_list: D000959:Antihypertensive Agents
keywords: frailty; hypertension; orthostatic hypotension