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Sprint hypertension

Yan Gong, Steven M Smith, Eileen M Handberg, Carl J Pepine, Rhonda M Cooper-DeHoff
The objective of this analysis is to determine the effect of intensive (<120 mm Hg) versus standard (<140 mm Hg) systolic blood pressure (SBP) targets on cardiovascular (CV) outcomes among SPRINT participants with low-normal or high-normal fasting glucose (FG). We categorized the 5425 SPRINT participants with FG <100 mg/dL into 2 groups: <85 mg/dL (low-normal) and 85 to <100 mg/dL (high-normal). Among participants with low-normal glucose, there was no significant difference in the primary outcome (PO) between the 2 treatment arms (adjusted hazard ratio, HR: 1...
March 13, 2018: Journal of Clinical Hypertension
Akanksha Bhatnagar, Ulrich Pein, Silke Markau, Karl Weigand, Paolo Fornara, Matthias Girndt, Eric Seibert
BACKGROUND/AIMS: We compare conventional office blood pressure measurements with automated SPRINT-study type readings in kidney transplant recipients in order to determine the impact of the white coat effect in a prospective observational study. METHODS: Adult patients with a functional renal transplant not dependent on dialysis were eligible. Readings were taken in the office in presence of the physician with an oscillometric method. Afterwards, readings were repeated with the patients resting alone in a quiet examination room with an automated blood pressure monitor...
March 6, 2018: Kidney & Blood Pressure Research
Robert A Phillips, Jiaqiong Xu, Leif E Peterson, Ryan M Arnold, Joseph A Diamond, Adam E Schussheim
BACKGROUND: The lower rate of primary outcome events in the intensive treatment group in SPRINT (Systolic Pressure Intervention Trial) was associated with increased clinically significant serious adverse events (SAEs). In 2017, the American College of Cardiology and American Heart Association issued risk-based blood pressure treatment guidelines. The authors hypothesized that stratification of the SPRINT population by degree of future cardiovascular disease (CVD) risk might identify a group which could benefit the most from intensive treatment...
March 2, 2018: Journal of the American College of Cardiology
Capri G Foy, Laura C Lovato, Mara Z Vitolins, Jeffrey T Bates, Ruth Campbell, William C Cushman, Stephen P Glasser, Avrum Gillespie, William J Kostis, Marie Krousel-Wood, Joseph B Muhlestein, Suzanne Oparil, Kwame Osei, Roberto Pisoni, Mark S Segal, Alan Wiggers, Karen C Johnson
BACKGROUND: To determine if the effects of intensive lowering of systolic blood pressure (goal of less than 120 mmHg) versus standard lowering (goal of less than 140 mmHg) upon cardiovascular, renal, and safety outcomes differed by gender. METHODS: Nine thousand three hundred and sixty-one men and women aged 50 years or older with systolic blood pressure of 130 mmHg or greater, taking 0-4 antihypertensive medications, and with increased risk of cardiovascular disease, but free of diabetes, were randomly assigned to either a systolic blood pressure target of less than 120 mmHg (intensive treatment) or a target of less than 140 mmHg (standard treatment)...
April 2018: Journal of Hypertension
Mattias Brunström, Bo Carlberg, Lars H Lindholm
No abstract text is available yet for this article.
February 27, 2018: Circulation
Muthiah Vaduganathan, Manan Pareek, Arman Qamar, Ambarish Pandey, Michael H Olsen, Deepak L Bhatt
BACKGROUND: The 2017 ACC/AHA guidelines include lower thresholds to define hypertension than previous guidelines. Little is known about the impact of these guideline changes in patients with or at high risk for cardiovascular disease. METHODS: In this exploratory analysis using baseline blood pressure assessments in SPRINT (Systolic Blood Pressure Intervention Trial), we evaluated the prevalence and associated cardiovascular prognosis of patients newly reclassified with hypertension based on the 2017 ACC/AHA (SBP≥130mmHg or DBP≥80mmHg) compared with the JNC 7 guidelines (SBP≥140mmHg or DBP≥90mmHg)...
February 5, 2018: American Journal of Medicine
Lama Ghazi, Suzanne Oparil
The Systolic Blood Pressure Intervention Trial is the first large prospective randomized controlled trial to demonstrate the benefit of an intensive systolic blood pressure (SBP) treatment target (<120 mm Hg) compared to a standard target (<140 mm Hg) in reducing cardiovascular morbidity and mortality and all-cause mortality in high-risk hypertensive patients. The impact of SPRINT on hypertension treatment has been large, but major questions remain about the feasibility of achieving the SPRINT intensive SBP target in routine practice, the generalizability of the SPRINT findings to hypertensive populations that were excluded from the trial, and the cost effectiveness of adopting the SPRINT intensive treatment goal...
January 29, 2018: Annual Review of Medicine
Steven G Chrysant
Systolic hypertension, especially isolated systolic hypertension (ISH) is very common in older subjects aged ≥ 65 years and is a major risk factor for cardiovascular disease (CVD), strokes, heart failure (HF) and chronic kidney disease (CKD). It is also, directly and linearly related with these complications irrespective of sex, or ethnicity, but it is worse with the advancement of age. Effective control of systolic blood pressure (SBP), is associated with significant reduction in the incidence of these complications...
February 1, 2018: Postgraduate Medicine
Michel Burnier, Grégoire Wuerzner
In the last 2 years, the attention of hypertension specialists has been focused on the results of the SPRINT trial and its post-hoc analyses and its possible implications for the management of hypertensive patients. While waiting for new European hypertension guidelines due in 2018, the year 2017 can be considered as a year of transition. Yet, several interesting clinical studies have been published which may affect the future management of hypertension. Thus we shall discuss new data on the benefits of eating more fruits and vegetables on cardiovascular mortality, the « quadpill » concept, the impact of various non-steroidal anti-inflammatory drugs on blood pressure and the most recent data on renal denervation...
January 10, 2018: Revue Médicale Suisse
Adam A Markovitz, Jacob A Mack, Brahmajee K Nallamothu, John Z Ayanian, Andrew M Ryan
OBJECTIVES: To assess the incremental effects of adding extra antihypertensive drugs from a new class to a patient's regimen. DESIGN: Instrumental variable analysis of data from SPRINT (Systolic Blood Pressure Intervention Trial). To account for confounding by indication-when treatments seem less effective if they are administered to sicker patients-randomization status was used as the instrumental variable. Patients' randomization status was either intensive (systolic blood pressure target <120 mm Hg) or standard (systolic blood pressure target <140 mm Hg) treatment...
December 22, 2017: BMJ: British Medical Journal
Kipp W Johnson, Benjamin S Glicksberg, Rachel A Hodos, Khader Shameer, Joel T Dudley
Hypertension is a major risk factor for ischemic cardiovascular disease and cerebrovascular disease, which are respectively the primary and secondary most common causes of morbidity and mortality across the globe. To alleviate the risks of hypertension, there are a number of effective antihypertensive drugs available. However, the optimal treatment blood pressure goal for antihypertensive therapy remains an area of controversy. The results of the recent Systolic Blood Pressure Intervention Trial (SPRINT) trial, which found benefits for intensive lowering of systolic blood pressure, have been debated for several reasons...
2018: Pacific Symposium on Biocomputing
Tom F Brouwer, Jim T Vehmeijer, Deborah N Kalkman, Wouter R Berger, Bert-Jan H van den Born, Ron J Peters, Reinoud E Knops
OBJECTIVE: The Action to Control Cardiovascular Risk in Diabetes Blood Pressure (ACCORD-BP) study did not find a significant beneficial effect of intensive systolic blood pressure (SBP) lowering on cardiovascular events in hypertensive patients with type 2 diabetes mellitus (T2DM), while the Systolic Blood Pressure Intervention Trial (SPRINT) did find a significant beneficial effect in patients without T2DM. The objective of this analysis was to assess the effect of both T2DM and baseline cardiovascular disease (CVD) risk on the treatment effect of intensive blood pressure lowering...
December 6, 2017: Diabetes Care
A Yannoutsos, A Bura-Rivière, P Priollet, J Blacher
OBJECTIVE: The issue of how far blood pressure (BP) should be lowered under antihypertensive treatment is still an important matter of scientific debate. The aim of the present review is to consider the clinical relevance of individualized BP goal under treatment in hypertensive patients according to their age, comorbidities or established cardio-vascular (CV) disease. DATA FROM THE LITERATURE: The French and European recommendations propose a systolic BP target between 130 and 139mmHg (<150mmHg after 80 years) and diastolic BP target <90mmHg in hypertensive patients whatever their level of risk...
December 2017: Journal de Médecine Vasculaire
Peter M Okin, Sverre E Kjeldsen, Richard B Devereux
BACKGROUND: The SPRINT study demonstrated that targeting systolic blood pressure (SBP) less than 120 mmHg was associated with lower cardiovascular event and mortality rates. In the LIFE study, however, a lower achieved SBP was associated with increased mortality. Mean baseline SBP in SPRINT was 140 mmHg and a third of the population had a baseline SBP 132 mmHg or less, raising the question of whether the lower baseline SBP in SPRINT could in part account for these differences. METHODS: All-cause mortality during 4...
April 2018: Journal of Hypertension
Carlos Aurelio Schiavon, Angela Cristine Bersch-Ferreira, Eliana Vieira Santucci, Juliana Dantas Oliveira, Camila Ragne Torreglosa, Priscila Torres Bueno, Julia Caldas Frayha, Renato Nakagawa Santos, Lucas Petri Damian, Patricia Malvina Noujaim, Helio Halpern, Frederico L J Monteiro, Ricardo Vitor Cohen, Carlos H Uchoa, Marcio Gonçalves de Souza, Celso Amodeo, Luiz Bortolotto, Dimas Ikeoka, Luciano F Drager, Alexandre Biasi Cavalcanti, Otavio Berwanger
BACKGROUND : Recent research efforts on bariatric surgery have focused on metabolic and diabetes mellitus resolution. Randomized trials designed to assess the impact of bariatric surgery in patients with obesity and hypertension are needed. METHODS : In this randomized, single-center, nonblinded trial, we included patients with hypertension (using ≥2 medications at maximum doses or >2 at moderate doses) and a body mass index between 30.0 and 39.9 kg/m2 Patients were randomized to Roux-en-Y gastric bypass plus medical therapy or medical therapy alone...
November 13, 2017: Circulation
F H Messerli, S Bangalore, S F Rimoldi
No abstract text is available yet for this article.
March 2018: Journal of Internal Medicine
Paul E Drawz, Joachim H Ix
Hypertension is the leading chronic disease risk factor in the world and is especially important in patients with CKD, nearly 90% of whom have hypertension. Recently, in the Systolic BP Intervention Trial (SPRINT), intensive lowering of clinic systolic BP to a target <120 mm Hg, compared with a standard BP target of <140 mm Hg, reduced risk for cardiovascular disease and all-cause mortality. However, because BP was measured unobserved using an automated device, some investigators have questioned the ability to translate SPRINT results into routine clinical practice, in which measurement of BP is typically less standardized...
February 2018: Journal of the American Society of Nephrology: JASN
Yoshitsugu Obi, Kamyar Kalantar-Zadeh, Ayumi Shintani, Csaba P Kovesdy, Takayuki Hamano
BACKGROUND: The Systolic Blood Pressure Intervention Trial (SPRINT; ClinicalTrials. gov, NCT01206062) reported reduced cardiovascular events by intensive blood pressure (BP) control among hypertensive patients without diabetes. However, the risk-benefit profile of intensive BP control may differ across estimated glomerular filtration rate (eGFR) levels. METHODS: This is a post-hoc analysis of the SPRINT. Non-diabetic hypertensive adults (n=9,361) with eGFR >20 mL/min/1...
October 16, 2017: Journal of Internal Medicine
Carolyn H Still, Carlos J Rodriguez, Jackson T Wright, Timothy E Craven, Adam P Bress, Glenn M Chertow, Paul K Whelton, Jeffrey C Whittle, Barry I Freedman, Karen C Johnson, Capri G Foy, Jiang He, John B Kostis, James P Lash, Carolyn F Pedley, Roberto Pisoni, James R Powell, Barry M Wall
BACKGROUND: The Systolic Blood Pressure Intervention Trial (SPRINT) showed that targeting a systolic blood pressure (SBP) of ≤ 120 mm Hg (intensive treatment) reduced cardiovascular disease (CVD) events compared to SBP of ≤ 140 mm Hg (standard treatment); however, it is unclear if this effect is similar in all racial/ethnic groups. METHODS: We analyzed SPRINT data within non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic subgroups to address this question...
December 8, 2017: American Journal of Hypertension
Rainer Düsing
The optimal target blood pressure (BP) in the treatment of hypertensive patients remains controversial. Recently, the systolic blood pressure trial (SPRINT) has proposed that a target systolic blood pressure of < 120 mmHg provides prognostic benefit in elderly hypertensive patients at high cardiovascular risk. The results of SPRINT contrast with several other intervention trials which have investigated the effect of intense BP lowering (Secondary Prevention of Small Subcortical Strokes [SPS3], Action to Control Cardiovascular Risk in Diabetes [ACCORD], Heart Outcomes Prevention Evaluation [HOPE]-3)...
September 2017: Deutsche Medizinische Wochenschrift
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