The SPRINT trial: A major advance in treating high blood pressure

Deepak Bhatt, MD, MPH

There are few advances in medicine that truly warrant an immediate change in practice, but the SPRINT trial appears to be one such study. In a recent press release, the SPRINT researchers announced that their study results showed aiming for a systolic blood pressure (the top number) of 120 mm Hg was superior to a target of 140 mm Hg. This one change reduced the risk of death by almost 25% and reduced the rate of overall cardiovascular problems, including heart attacks, strokes, and heart failure, by almost a third — welcome news to every doctor and patient.

The SPRINT trial was a randomized clinical trial that followed over 9,000 Americans for several years. All participants in the trial were ages 50 and older, had high blood pressure, and also either were at increased risk for heart disease or had kidney disease. Half the participants were given a blood pressure target of 120 mm Hg and the other half were given a target of 140 mm Hg. On average, the 120 mm Hg group needed 3 blood pressure medications to achieve this goal, and the 140 mm Hg group needed 2.

This study was sponsored primarily by the National Heart, Lung, and Blood Institute of the National Institutes of Health. This trial is a wonderful example of the kind of long-term, large-scale clinical trials that are necessary to advance patient care meaningfully. The study results also illustrate the importance of randomized clinical trials — that is, studies in which patients are randomly assigned to one of two treatment arms. Lastly, credit must be given to the participants who consented to be enrolled in the study. They have generously and selflessly contributed to advancing medical science and improving the care of patients worldwide. Ultimately, they also helped improve their own care.

While the results are very exciting, it will be important to see the details in the full text of the study, which has yet to be published. Sometimes a published paper provides more subtle interpretations of the findings than an initial press release. Those usual caveats notwithstanding, these results appear to be an important discovery with instant applicability.

It usually takes years before the effects of high blood pressure (at least, in the range being studied in this trial) cause serious cardiovascular problems. So, for people with reasonably well-controlled blood pressure, there is no need to rush to see your doctor right away.

However, even if your blood pressure is considered well-controlled under current standards, it would be worthwhile to discuss with your primary care physician whether a lower target blood pressure would be in order. Of course, you and your physician would need to balance the benefits noted in the SPRINT trial against the potential risks of taking additional blood pressure medications and their possible side effects. The risk of side effects might be higher in certain groups of patients, such as older people taking several different types of drugs. Still, the availability of multiple generic blood pressure medicines should allow these results to be applied in the vast majority of people with high blood pressure.

Related Information: Controlling Your Blood Pressure


  1. Doug Miller

    I was really surprised to see this study. Back in the 1980’s, when I was still in my 30’s, my blood pressure had crept up to about 140/90. My family doc told me at that time that, in the past, we would not treat this. But recent studies (remember this is the 1980″s) indicated better outcomes if we aggressively treat any blood pressure over 120/80. And, that’s what we did. Started with a calcium channel blocker, which didn’t bring it all he way back to normal, so we added an ACE inhibitor. (They are combined in one pill). That brought it down to 120/80. SInce then I have lost weight and become a much more diligent exercise enthusiast. On the same dose, my blood pressure will often be close to 110/70. The surprise (to me) is that this study brings new guidelines.

  2. mohsen

    Hi sir
    I’m medical student. I work on sirtuin gene in hypertension. I ask you to guide me for find a proposal topic to reach this gene in my brain biopsy sample that is received from rat which induced hypertrophy on they with aortic banding.

    thanks a lot

  3. Joanne Fisher

    I concur with Hadley. A whole-food, plant-based diet is extremely anti-inflammatory and has plenty of protein sources. Indications are that the current guidelines for protein are much higher than necessary. (check out John McDougall for a thorough review.) You might also look at Rip Esselstyn’s story. He grew up vegan, was a tri-athlete, is extremely buff, and I do not see him promoting protein supplements.

  4. Hadley V. Baxendale

    If you eat plenty of beans, you don’t need a protein powder.

  5. Cathy

    I am a 61 year old female and started my headaches at 9 years old. Throughout this time I found my trigger foods and stayed away from them and if I got a headaches I had my own regime of what I took to get rid of the headache. In March of 2014 I ended up with a venous sinus thrombosis and no more could I take my regime to rid a headache. Pain pills didn’t work. Demerol has calcium sulfate that could cause a headache so that didn’t work. Out of the blue I remembered things I couldn’t eat one being Equal cause I knew Phenylalanine caused me a headache but I didn’t know that Phenylalanine is in all our foods especially meats poultry and fish big time. So I put all that down and haven’t had a headache.!! I replace it w beans. Also going to add a Phenylalanine Free protein powder. I was taking protein powder and had ungodly headaches not knowing it’s the a Phenylalanine (amino acid) that was causing it. So try it!!! I also stay away from Inflamatory foods cause obviously they cn cause headaches too.

    • Hadley V. Baxendale

      If you are eating plenty of beans, then you don’t need a protein drink and ipso facto you don’t need to go looking for a phenylalanine-free protein powder. Right?