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Applying the Systolic Blood Pressure Intervention Trial Results to Older Adults
Author(s) -
Supiano Mark A.,
Williamson Jeff D.
Publication year - 2017
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.14681
Subject(s) - medicine , blood pressure , intervention (counseling) , physical therapy , gerontology , cardiology , nursing
The Systolic Blood Pressure Intervention Trial ( SPRINT ; ClinicalTrials.gov, NCT 01206062) 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?