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The case for absolute cardiovascular risk-based blood pressure-lowering treatment decisions: data from the SPRINT trial

Journal of Human Hypertension volume 34, pages 544–545 (2020)Cite this article

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In this analysis of the SPRINT trial, a blood pressure-lowering treatment strategy based on CVD risk prevented more events and resulted in treatment of fewer persons than a strategy based on systolic blood pressure, across a wide range of potential treatment thresholds including below 140 mmHg. This supports guidelines that recommend cardiovascular risk assessment to guide blood pressure-lowering treatment decisions.

Lowering blood pressure provides similar relative risk reductions at all levels of baseline cardiovascular risk, but progressively greater absolute risk reductions as baseline risk increases [1]. We recently demonstrated that a blood pressure-lowering treatment strategy based on predicted cardiovascular risk is more effective than one based on systolic blood pressure level [2]. The trials included in that study included persons with high blood pressure ranges, and it is uncertain if the results apply to lower ranges.

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Authors and Affiliations

  1. Department of Medical Sciences, Uppsala University, Uppsala, Sweden

    Johan Sundström

  2. The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia

    Johan Sundström

  3. Department of Medicine, Northwestern University, Chicago, IL, USA

    Kunal N. Karmali

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  1. Johan Sundström
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  2. Kunal N. Karmali
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Correspondence to Johan Sundström.

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Sundström, J., Karmali, K.N. The case for absolute cardiovascular risk-based blood pressure-lowering treatment decisions: data from the SPRINT trial. J Hum Hypertens 34, 544–545 (2020). https://doi.org/10.1038/s41371-019-0260-5

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  • DOI: https://doi.org/10.1038/s41371-019-0260-5

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