This trial is active, not recruiting.

Condition hypertension
Treatments intensive control of sbp, standard bp arm
Sponsor National Heart, Lung, and Blood Institute (NHLBI)
Collaborator National Institute on Aging (NIA)
Start date October 2010
End date June 2016
Trial size 9361 participants
Trial identifier NCT01206062, 268200900040C-1-0-1, SPRINT


Elevated blood pressure (BP) is an important public health concern. It is highly prevalent, the prevalence may be increasing, and it is a risk factor for several adverse health outcomes, especially coronary heart disease, stroke, heart failure, chronic kidney disease, and decline in cognitive function. The Systolic Blood Pressure Intervention Trial (SPRINT) is a 2-arm, multicenter, randomized clinical trial designed to test whether a treatment program aimed at reducing systolic blood pressure (SBP) to a lower goal than currently recommended will reduce cardiovascular disease (CVD) risk.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Allocation randomized
Endpoint classification efficacy study
Intervention model parallel assignment
Masking single blind (outcomes assessor)
Primary purpose treatment
Participants randomized into the Intensive BP arm will have a goal of SBP <120 mm Hg. 2-drug therapy initiated in most Intensive participants; age ≥75 years and SBP 130-139 mm Hg on 0-1 drug; may begin with 1 drug, but add second at 1 month if SBP ≥130 mm Hg; drugs added and/or titrated at each visit (monthly) to achieve SBP <120 mm Hg; at periodic "milepost" visits: addition of another drug "required" if not at goal.
intensive control of sbp Lower target for SBP
Participants in the Intensive arm have a goal of SBP <120 mm Hg. Use of once-daily antihypertensive agents will be encouraged unless alternative frequency is indicated/necessary. One or more medications from the following classes of agents will be provided by the study for use in managing participants in both randomization groups to achieve study goals: Angiotension converting enzyme (ACE)-inhibitors Angiotension receptor blockers (ARBs) Direct vasodilators Thiazide-type diuretics Loop diuretics Potassium-sparing diuretics Beta-blockers Sustained-release calcium channel blockers (CCBs) Alpha1-receptor blockers Sympatholytics Combination products will be available, depending on cost, utility, or donations from pharmaceutical companies.
(Active Comparator)
Participants randomized into the Standard arm will have a goal of SBP <140 mm Hg. Intensify therapy if SBP ≥160 mm Hg @ 1 visit; ≥140 mm Hg @ 2 consecutive visits; Down-titration if SBP <130 mm Hg @ 1 visit; <135 mm Hg @ 2 consecutive visits
standard bp arm Control of SBP to a target of 140 mm Hg
Participants in the Standard BP arm have a goal of SBP <140 mm Hg. The same medications used in the Intensive BP arm will be used for the Standard BP arm.

Primary Outcomes

First occurrence of a myocardial infarction (MI), acute coronary syndrome (ACS), stroke, heart failure (HF), or CVD death
time frame: 6 years

Secondary Outcomes

All-cause mortality
time frame: 6 years
Decline in renal function
time frame: 6 years
Development of end stage renal disease (ESRD),
time frame: 6 years
time frame: 6 years
Decline in cognitive function
time frame: 6 years
Small vessel cerebral ischemic disease
time frame: 6 years

Eligibility Criteria

Male or female participants at least 50 years old.

Inclusion Criteria: - At least 50 years old Systolic blood pressure of - 130 - 180 mm Hg on 0 or 1 medication - 130 - 170 mm Hg on up to 2 medications - 130 - 160 mm Hg on up to 3 medications - 130 - 150 mm Hg on up to 4 medications Risk (one or more of the following) 1. Presence of clinical or subclinical cardiovascular disease other than stroke 2. CKD, defined as eGFR 20 - 59 ml/min/1.73m2 3. A Framingham Risk Score for 10-year CVD risk ≥ 15% 4. Age greater than 75 years Exclusion Criteria: - An indication for a specific BP lowering medication that the person is not taking and the person has not been documented to be intolerant of the medication class. - Known secondary cause of hypertension that causes concern regarding safety of the protocol. - One minute standing SBP < 110 mm Hg. - Proteinuria in the following ranges (based on a measurement within the past 6 months) - 24 hour urinary protein excretion ≥1 g/day, or - 24 hour urinary albumin excretion ≥ 600 mg/day, or - spot urine protein/creatinine ratio ≥ 1 g/g creatinine, or - spot urine albumin/creatinine ratio ≥ 600 mg/g creatinine, or - urine dipstick ≥ 2+ protein - Arm circumference too large or small to allow accurate blood pressure measurement with available devices - Diabetes mellitus, - History of stroke (not CE or stenting) - Diagnosis of polycystic kidney disease - Glomerulonephritis treated with or likely to be treated with immunosuppressive therapy - eGFR < 20 ml/min /1.73m2 or end-stage renal disease (ESRD) - Cardiovascular event or procedure (as defined above as clinical CVD for study entry) or hospitalization for unstable angina within last 3 months - Symptomatic heart failure within the past 6 months or left ventricular ejection fraction (by any method) < 35% - A medical condition likely to limit survival to less than 3 years or a malignancy other than non-melanoma skin cancer within the last 2 years - Any factors judged by the clinic team to be likely to limit adherence to interventions. - Failure to obtain informed consent from participant - Currently participating in another clinical trial (intervention study). Note: Patient must wait until the completion of his/her activities or the completion of the other trial before being screened for SPRINT. - Living in the same household as an already randomized SPRINT participant - Any organ transplant - Unintentional weight loss > 10% in last 6 months - Pregnancy, currently trying to become pregnant, or of child-bearing potential and not using birth control.

Additional Information

Official title Systolic Blood Pressure Intervention Trial
Principal investigator David M. Reboussin, PhD
Description SPRINT will randomize about 9250 participants aged ≥ 50 years with SBP ≥130 mm Hg and at least one additional CVD risk factor. The trial will compare the effects of randomization to a treatment program of an intensive SBP goal with randomization to a treatment program of a standard goal. Target SBP goals are <120 vs <140 mm Hg, respectively, to create a minimum mean difference of 10 mm Hg between the two randomized groups. The primary hypothesis is that CVD event rates will be lower in the intensive arm. Participants will be recruited at approximately 90 clinics within 5 clinical center networks (CCNs) over approximately a 2-year period, and will be followed for 4-6 years.
Trial information was received from ClinicalTrials.gov and was last updated in September 2016.
Information provided to ClinicalTrials.gov by National Heart, Lung, and Blood Institute (NHLBI).