Impact of the SPRINT Trial on Hypertension Management

Annu Rev Med. 2018 Jan 29:69:81-95. doi: 10.1146/annurev-med-050416-024516.


The Systolic Blood Pressure Intervention Trial is the first large prospective randomized controlled trial to demonstrate the benefit of an intensive systolic blood pressure (SBP) treatment target (<120 mm Hg) compared to a standard target (<140 mm Hg) in reducing cardiovascular morbidity and mortality and all-cause mortality in high-risk hypertensive patients. The impact of SPRINT on hypertension treatment has been large, but major questions remain about the feasibility of achieving the SPRINT intensive SBP target in routine practice, the generalizability of the SPRINT findings to hypertensive populations that were excluded from the trial, and the cost effectiveness of adopting the SPRINT intensive treatment goal. In this review, we discuss the generalizability of SPRINT data to the general population of adults with hypertension and with various comorbidities, the cost effectiveness of intensive SBP-lowering therapy, and the implications of SPRINT for future hypertension guideline development and clinical practice.

Keywords: Systolic Blood Pressure Intervention Trial, blood pressure; cardiovascular disease; heart failure; hypertension management.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Antihypertensive Agents / economics
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure
  • Cost-Benefit Analysis
  • Heart Failure / economics
  • Heart Failure / epidemiology*
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / economics
  • Hypertension / physiopathology
  • Mortality
  • Patient Care Planning*
  • Randomized Controlled Trials as Topic


  • Antihypertensive Agents