Applying the Systolic Blood Pressure Intervention Trial Results to Older Adults

详细信息    查看全文

• 作者：Mark A. Supiano and Jeff D. Williamson
• 刊名：Journal of the American Geriatrics Society
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：65
• 期：1
• 页码：16-21
• 全文大小：103K
• ISSN：1532-5415

文摘

The Systolic Blood Pressure Intervention Trial (SPRINT; ClinicalTrials.gov, NCT01206062) was stopped early because of significantly lower risk of cardiovascular disease in participants randomized to a systolic blood pressure target of 120 mmHg (intensive) than in those randomized to 140 mmHg (standard). The cardiovascular outcome benefit was also identified in subjects aged 75 and older assigned to the intensive arm—34% lower than in the standard arm—in addition to 33% lower all-cause mortality at 3.14 years of follow-up. These beneficial outcomes held in older participants characterized as frail or with impaired gait speed. This article addresses several questions that need to be considered in applying the SPRINT results to the clinical care of older adults: Why are the SPRINT results discordant from those of epidemiological studies? Do the SPRINT findings generalize to the frail, older adults that I care for? Were there more adverse events in the intensive treatment group? What about cognitive and kidney outcomes? What are future considerations, and how low should we go?