Looks at blood pressure control and relationship to risk of heart and kidney diseases, stroke, and cognitive decline

More than 900 million adults worldwide and nearly one in three adult Americans have high blood pressure—one of the most common conditions among middle-aged and older adults. The National Institutes of Health (NIH) now has launched a large multicenter randomized clinical trial to determine whether maintaining blood pressure levels lower than current recommendations can further reduce the risk of cardiovascular and kidney diseases or age-related cognitive decline.

Called the Systolic Blood Pressure Intervention Trial (SPRINT), the nine-year, $114 million study will be conducted in more than 80 clinical sites across the United States; the University of Colorado Denver’s School of Medicine is a selected site and will be recruiting participants for the trial.

“This is one of the largest NIH studies ever done around blood pressure control in patients with cardiovascular and kidney diseases,” said Michel Chonchol, MD, associate professor of Renal Medicine at CU Denver’s School of Medicine and principal investigator for the Denver site. “The patient population that will be enrolled in this trial—7,500 people nationwide—will provide forceful and definitive study outcomes around the proper regulation of blood pressure as relates to decreasing the risk of cardiovascular and kidney disease.”

High blood pressure is a leading risk factor for stroke, heart disease, kidney failure, and other conditions and is also a key contributor to the development and progression of chronic kidney disease. SPRINT will examine the hypothesis that more aggressive blood pressure control will slow the development of chronic kidney disease beyond the benefit achieved by current blood pressure goals.

Current clinical guidelines recommend systolic pressure (the top number in a blood pressure reading) of less than 140 millimeters of mercury (mm Hg) for healthy adults, and 130 mm Hg for adults with kidney disease or diabetes. SPRINT will evaluate the potential benefits of maintaining systolic blood pressure at less than 120 mm Hg for adults who are at risk for heart disease or kidney disease. The study will also assess possible risks of this therapeutic strategy.

Study participants will be treated with commonly available blood pressure medications to achieve one of two different levels of blood pressure control – either less than 140 mm Hg (standard group) or less than 120 mm Hg (treatment group). Those in the treatment group will take an average of three to four medications; those in the standard group will take about two medications. SPRINT participants will be seen in clinic every few months at the beginning of the study and less frequently as their blood pressure is controlled. The study will include standard tests for determining the health of the heart, kidneys, and brain.

“To determine if a lower blood pressure goal reduces the risk of complications and death more than standard treatment to the current recommended goal level, we need evidence-based research. Only a large, long-term clinical trial comparing the two levels will give us the answer,” said Elizabeth G. Nabel, MD, director of the National Heart, Lung, and Blood Institute (NHLBI). “If this study shows that maintaining a lower systolic blood pressure has significant benefits for middle-aged and older adults—and doctors and patients meet the lower goal levels—we could see hundreds of thousands fewer heart attacks and stroke each year in the United States alone.”

SPRINT is funded by the NHLBI and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Two other NIH institutes – the National Institute of Neurological Disorders and Stroke (NINDS), and the National Institute on Aging (NIA) – will support SPRINT-MIND, a sub-study that focuses on the impact of lowering systolic blood pressure to reduce cognitive impairment, an important early indication of dementia.

The National Institutes of Health — The Nation’s Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Faculty at the University of Colorado Denver’s School of Medicine work to advance science and improve care. These faculty members include physicians, educators and scientists at University of Colorado Hospital, The Children’s Hospital, Denver Health, National Jewish Health, and the Denver Veterans Affairs Medical Center. Degrees offered by the CU Denver School of Medicine include doctor of medicine, doctor of physical therapy, and masters of physician assistant studies. The School is located on the University of Colorado’s Anschutz Medical Campus, one of four campuses in the University of Colorado system. For additional news and information, please visit the CU Denver newsroom online.

Contact: Tonya Ewers Maikish, 303.315.6374, [email protected]

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