Systolic Blood Pressure Intervention Trial (SPRINT)
Elevated blood pressure (BP) is an important public health concern. It is highly prevalent, the prevalence may be increasing, and it is a risk factor for several adverse health outcomes, especially coronary heart disease, stroke, heart failure, chronic kidney disease, and decline in cognitive function. The Systolic Blood Pressure Intervention Trial (SPRINT) is a 2-arm, multicenter, randomized clinical trial designed to test whether a treatment program aimed at reducing systolic blood pressure (SBP) to a lower goal than currently recommended will reduce cardiovascular disease (CVD) risk.
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
|Official Title:||Systolic Blood Pressure Intervention Trial|
- First occurrence of a myocardial infarction (MI), acute coronary syndrome (ACS), stroke, heart failure (HF), or CVD death [ Time Frame: 6 years ] [ Designated as safety issue: No ]
- All-cause mortality [ Time Frame: 6 years ] [ Designated as safety issue: No ]
- Decline in renal function [ Time Frame: 6 years ] [ Designated as safety issue: No ]
- Development of end stage renal disease (ESRD), [ Time Frame: 6 years ] [ Designated as safety issue: No ]
- Dementia [ Time Frame: 6 years ] [ Designated as safety issue: No ]
- Decline in cognitive function [ Time Frame: 6 years ] [ Designated as safety issue: No ]
- Small vessel cerebral ischemic disease [ Time Frame: 6 years ] [ Designated as safety issue: No ]
|Study Start Date:||October 2010|
|Estimated Study Completion Date:||December 2018|
|Estimated Primary Completion Date:||October 2018 (Final data collection date for primary outcome measure)|
Experimental: Intensive BP Arm
Participants randomized into the Intensive BP arm will have a goal of SBP <120 mm Hg. 2-drug therapy initiated in most Intensive participants; age ≥75 years and SBP 130-139 mm Hg on 0-1 drug; may begin with 1 drug, but add second at 1 month if SBP ≥130 mm Hg; drugs added and/or titrated at each visit (monthly) to achieve SBP <120 mm Hg; at periodic "milepost" visits: addition of another drug "required" if not at goal.
Other: Intensive control of SBP
Participants in the Intensive arm have a goal of SBP <120 mm Hg. Use of once-daily antihypertensive agents will be encouraged unless alternative frequency is indicated/necessary. One or more medications from the following classes of agents will be provided by the study for use in managing participants in both randomization groups to achieve study goals:
Angiotension converting enzyme (ACE)-inhibitors Angiotension receptor blockers (ARBs) Direct vasodilators Thiazide-type diuretics Loop diuretics Potassium-sparing diuretics Beta-blockers Sustained-release calcium channel blockers (CCBs) Alpha1-receptor blockers Sympatholytics
Combination products will be available, depending on cost, utility, or donations from pharmaceutical companies.
Active Comparator: Standard BP Arm
Participants randomized into the Standard arm will have a goal of SBP <140 mm Hg. Intensify therapy if SBP ≥160 mm Hg @ 1 visit; ≥140 mm Hg @ 2 consecutive visits; Down-titration if SBP <130 mm Hg @ 1 visit; <135 mm Hg @ 2 consecutive visits
Other: Standard BP arm
Participants in the Standard BP arm have a goal of SBP <140 mm Hg. The same medications used in the Intensive BP arm will be used for the Standard BP arm.
Other Name: Control of SBP to a target of 140 mm Hg
SPRINT will randomize about 9250 participants aged ≥ 50 years with SBP ≥130 mm Hg and at least one additional CVD risk factor. The trial will compare the effects of randomization to a treatment program of an intensive SBP goal with randomization to a treatment program of a standard goal. Target SBP goals are <120 vs <140 mm Hg, respectively, to create a minimum mean difference of 10 mm Hg between the two randomized groups. The primary hypothesis is that CVD event rates will be lower in the intensive arm. Participants will be recruited at approximately 90 clinics within 5 clinical center networks (CCNs) over approximately a 2-year period, and will be followed for 4-6 years.
|United States, North Carolina|
|Wake Forest University School of Medicine|
|Winston-Salem, North Carolina, United States, 27157|
|Principal Investigator:||David M. Reboussin, PhD||Wake Forest University|
|Principal Investigator:||Jackson T Wright, MD||Case Western Reserve University|
|Principal Investigator:||Alfred Cheung, MD||University of Utah|
|Principal Investigator:||Suzanne Oparil, MD||University of Alabama at Birmingham|
|Principal Investigator:||Mike Rocco, MD||Wake Forest University|
|Principal Investigator:||Bill Cushman, MD||Memphis VA Medical Center|