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SPRINT randomized more than 9,000 adults at increased cardiovascular risk to an intensive systolic blood-pressure target below 120 mmHg or a standard target below 140 mmHg. Intensive treatment significantly reduced the composite cardiovascular outcome and all-cause mortality. The study reshaped the discussion around blood-pressure targets, while also highlighting the potential trade-offs of more intensive therapy, including hypotension, syncope, electrolyte abnormalities and acute kidney injury. For general physicians, SPRINT is best interpreted as a framework for selected high-risk patients rather than a universal target applied without context. Accurate measurement technique is essential, and treatment intensity should reflect age, frailty, orthostatic symptoms, kidney function and overall cardiovascular risk. The trial's importance to resistant-hypertension discussions is also conceptual: reaching lower targets often requires combination therapy and attention to adherence, sodium intake, sleep, weight and secondary causes. In routine practice, the value of a target depends on the quality of the measurement and the consistency with which therapy is monitored and adjusted.
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SPRINT randomized more than 9,000 adults at increased cardiovascular risk to an intensive systolic blood-pressure target below 120 mmHg or a standard target below 140 mmHg. Intensive treatment significantly reduced the composite cardiovascular outcome and all-cause mortality. The study reshaped the discussion around blood-pressure targets, while also highlighting the potential trade-offs of more intensive therapy, including hypotension, syncope, electrolyte abnormalities and acute kidney injury. For general physicians, SPRINT is best interpreted as a framework for selected high-risk patients rather than a universal target applied without context. Accurate measurement technique is essential, and treatment intensity should reflect age, frailty, orthostatic symptoms, kidney function and overall cardiovascular risk. The trial's importance to resistant-hypertension discussions is also conceptual: reaching lower targets often requires combination therapy and attention to adherence, sodium intake, sleep, weight and secondary causes. In routine practice, the value of a target depends on the quality of the measurement and the consistency with which therapy is monitored and adjusted.
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