Intensive Blood Pressure Control Might Add Up to 3 Years of Life

By Amy Orciari Herman

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM

Adults at high cardiovascular risk who receive intensive blood pressure treatment may gain from 6 months to 3 years in life expectancy, according to a subanalysis from the SPRINT trial published in JAMA Cardiology.

In SPRINT, nearly 9400 high-risk, nondiabetic adults with systolic BP of 130–180 mm Hg were randomized to intensive BP control (systolic target, <120 mm Hg) or standard control (target, <140 mm Hg). The trial was stopped early, after roughly 3 years, when the intensive-treatment arm showed significant reductions in cardiovascular events and overall mortality.

Assuming that continued intensive treatment would provide consistent benefits over the long term, researchers now estimate that residual survival at age 50 was 37.3 years with intensive treatment versus 34.4 years with standard treatment. At age 65 years, residual survival was 24.5 versus 23.3 years, and at age 80, it was 11.9 versus 11.1 years.

Dr. Harlan Krumholz, editor-in-chief of NEJM Journal Watch Cardiology, weighed in: "This report translates the positive trial findings into life expectancy, but of course, the benefit is uneven. Not everyone gains 6 months — some gain a lot, some not so much. And so, for patients, this may not convey well what they can expect from tight control."