Intensive BP Reduction for Preventing Major Adverse Cardiovascular Events

In the 2015 SPRINT trial, patients with high cardiovascular (CV) risk but without diabetes or prior stroke had lower risk for major adverse CV events when blood pressure (BP) treatment was targeted to a systolic BP (SBP) of <120 mm Hg, rather than <140 mm Hg (NEJM JW Gen Med Dec 15 2015 and N Engl J Med 2015; 373:2103). However, three additional trials — ACCORD (NEJM JW Gen Med Apr 15 2010 and N Engl J Med 2010; 362:1575), SPS3 (NEJM JW Neurol Sep 2013 and Lancet 2013; 382:507), and RESPECT (NEJM JW Gen Med Dec 15 2019 and JAMA Neurol 2019; 76:1309) — showed no significant difference in outcomes between intensive and standard SBP targets in high-risk patients with diabetes or prior stroke. So the appropriate SBP target for some subgroups of…