SOURCE: Williamson JD, Supiano MA, Applegate WB, et al. Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged ≥ 75 years: A randomized clinical trial. JAMA 2016;315:2673-2682.
Hypertension experts and generalists alike consider the Systolic Blood Pressure Intervention Trial (SPRINT) a game changer. Despite the advice from Eighth Joint National Committee that lowering blood pressure to < 140/90 mmHg was sufficient for most non-senior adults, the question of whether lower is better was never believed to have been adequately clarified. SPRINT determined that aiming for a systolic blood pressure of < 120 mmHg provided significant reductions in cardiovascular and all-cause mortality compared to “traditional” blood pressure goals (< 140 mmHg systolic blood pressure) in hypertensive non-diabetic adults. SPRINT also was large enough (n = 9,361) and included a sufficient number of patients > 75 years of age (n = 2,636) to make meaningful commentary about benefits in that specific age demographic.
After a median of 3.14 years follow-up in patients > 75 years of age (mean age = 80 years), major adverse cardiovascular events fell by approximately one-third in the intensively treated group, as was all-cause mortality, without incurring excess serious adverse events.
SPRINT is not the first clinical trial to confirm benefits of treating hypertension in super-seniors: the Hypertension in the Very Elderly Trial (HYVET; mean age = 83 years) ended early due to the important mortality reductions observed in treated seniors attributable to blood pressure control. Using available knowledge, age should not be considered a barrier to seeking good blood pressure control.