The SPRINT Research Group Original Article A Randomized Trial of Intensive versus Standard Blood-Pressure Control The SPRINT Research Group N Engl J Med Volume 373(22):2103-2116 November 26, 2015

Study Overview Patients at increased cardiovascular risk but without diabetes were assigned to intensive treatment of systolic BP (target, <120 mm Hg) or standard treatment (target, <140 mm Hg). After a median of 3.26 years, the rate of cardiovascular events was significantly lower with intensive treatment.

Eligibility, Randomization, and Follow-up. Figure 1 Eligibility, Randomization, and Follow-up. Discontinued intervention refers to participants who discontinued the study treatment but did not withdraw consent or become lost to follow-up. The SPRINT Research Group. N Engl J Med 2015;373:2103-2116

Systolic Blood Pressure in the Two Treatment Groups over the Course of the Trial. Figure 2 Systolic Blood Pressure in the Two Treatment Groups over the Course of the Trial. The systolic blood-pressure target in the intensive-treatment group was less than 120 mm Hg, and the target in the standard-treatment group was less than 140 mm Hg. The mean number of medications is the number of blood-pressure medications administered at the exit of each visit. I bars represent 95% confidence intervals. The SPRINT Research Group. N Engl J Med 2015;373:2103-2116

Primary Outcome and Death from Any Cause. Figure 3 Primary Outcome and Death from Any Cause. Shown are the cumulative hazards for the primary outcome (a composite of myocardial infarction, acute coronary syndrome, stroke, heart failure, or death from cardiovascular causes) (Panel A) and for death from any cause (Panel B). The inset in each panel shows the same data on an enlarged y axis. CI denotes confidence interval. The SPRINT Research Group. N Engl J Med 2015;373:2103-2116

Forest Plot of Primary Outcome According to Subgroups. Figure 4 Forest Plot of Primary Outcome According to Subgroups. The dashed vertical line represents the hazard ratio for the overall study population. The box sizes are proportional to the precision of the estimates (with larger boxes indicating a greater degree of precision). The subgroup of no previous chronic kidney disease (CKD) includes some participants with unknown CKD status at baseline. Black race includes Hispanic black and black as part of a multiracial identification. The SPRINT Research Group. N Engl J Med 2015;373:2103-2116

Baseline Characteristics of the Study Participants. Table 1 Baseline Characteristics of the Study Participants. The SPRINT Research Group. N Engl J Med 2015;373:2103-2116

Primary and Secondary Outcomes and Renal Outcomes. Table 2 Primary and Secondary Outcomes and Renal Outcomes. The SPRINT Research Group. N Engl J Med 2015;373:2103-2116

Serious Adverse Events, Conditions of Interest, and Monitored Clinical Events. Table 3 Serious Adverse Events, Conditions of Interest, and Monitored Clinical Events. The SPRINT Research Group. N Engl J Med 2015;373:2103-2116

Conclusions Among patients at high risk for cardiovascular events but without diabetes, targeting a systolic blood pressure of less than 120 mm Hg, as compared with less than 140 mm Hg, resulted in lower rates of fatal and nonfatal major cardiovascular events and death from any cause, although significantly higher rates of some adverse events were observed in the intensive-treatment group.