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Therapeutics
Intensive versus standard blood pressure treatment improves cardiovascular outcomes without any difference in patient-reported outcomes
  1. David McCartney,
  2. Richard J McManus
  1. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  1. Correspondence to Professor Richard J McManus, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK; richard.mcmanus{at}phc.ox.ac.uk

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Commentary on: Berlowitz DR, Foy CG, Kazis LE, et al. Effect of intensive blood-pressure treatment on patient-reported outcomes. N Engl J Med 2017;377:733–44.

Context

The Systolic Blood Pressure Intervention Trial (SPRINT) was a large, multicentre, randomised controlled trial (RCT) originally reported in 2015.1 The trial randomly assigned 9361 individuals with hypertension at high risk of cardiovascular disease (but without diabetes or stroke) to intensive blood pressure (BP) control (systolic BP less than 120 mm Hg) or standard BP control (systolic BP less than 140 mm Hg). There was a significant reduction in cardiovascular events and mortality in the intensive treatment group and the trial was stopped early. The original trial reported a doubling of treatment-related serious adverse events including symptomatic hypotension, syncope and acute kidney injury in the intensive treatment group.1 This follow-on analysis presents the patient-reported outcomes of physical and mental health, and patient-reported adherence to treatment.2

Methods

SPRINT was an open-label RCT and recruited individuals over 50 years of age with a systolic BP between 130 and 180 mm …

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