What evidence does SPRINT provide that intensive SBP lowering reduces CV events and death in those at high CV risk?
SPRINT provides evidence that intensive SBP lowering reduces CV events and death in those at high CV risk. Those benefits targeting SBP <120 mm Hg compared to <140 mm Hg in SPRINT extended to CKD, the elderly, and those with frailty. A prespecified analysis of the benefits of targeting SBP <120 mm Hg in SPRINT included a significant reduction in the combined endpoint of probable dementia and mild cognitive impairment, with no interaction with baseline CKD. Secondary analyses further suggest that the beneficial effect of intensive BP lowering on the incidence of mild cognitive impairment may extend to those with and those who are aged 80 years or older. A recent meta-analysis of 74 RCTs concluded that the effect of BP lowering differed by baseline BP with no clear effect on death or CV disease in participants with no prior coronary heart disease and SBP <140 mm Hg at baseline.