SPRINT trial – hypertension. Inside Health 2/2/16

Notes on SPRINT
Trial: http://www.nejm.org/doi/full/10.1056/NEJMoa1511939#t=articleResults

also of note
http://www.cochrane.org/CD006742/HTN_benefits-of-antihypertensive-drugs-for-mild-hypertension-are-unclear
http://cks.nice.org.uk/chronic-kidney-disease-not-diabetic#!scenariorecommendation:5
http://cks.nice.org.uk/hypertension-not-diabetic

This was a
randomised controlled trial 9391 people without diabetes at high risk of CVS events
and with BP of over 130mm HG
not blinded

average bp 121 in rx group, 134.6 in normal rx group
outcomes – MI, stroke, HF, death from CVS causes
2 groups target either less than 140 or less than 120mmHg
stopped early after 3 and a half years (planned for 5 years) due to more aggressive BP lowering looking like much better option – death rates between the groups started to change after 2 years

The relative risk of death from cardiovascular causes was 43% lower with the intensive intervention than with the standard treatment (P=0.005) (Table 2).
The numbers needed to treat to prevent a primary outcome event, death from any cause, and death from cardiovascular causes during the median 3.26 years of the trial were 61, 90, and 172, respectively.

double the amount of serious adverse effects

A total of 220 participants in the intensive-treatment group (4.7%) and 118 participants in the standard-treatment group (2.5%) had serious adverse events that were classified as possibly or definitely related to the intervention (hazard ratio, 1.88; P<0.001 – low blood pressure ,faints , slow heart rate
double the amount of acute kidney injury/failure from 2.6% to 4.4%
approaching  1 in 20 people .

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