Landmark NIH study shows intensive blood pressure management may save lives

Release: Friday, September 11, 2015, 10:30 a.m. EDT

Lower blood pressure target greatly reduces cardiovascular complications and deaths in older adults

More intensive management of high blood pressure, below a commonly recommended blood pressure target, significantly reduces rates of cardiovascular disease, and lowers risk of death in a group of adults 50 years and older with high blood pressure. This is according to the initial results of a landmark clinical trial sponsored by the National Institutes of Health called the Systolic Blood Pressure Intervention Trial (SPRINT). The intervention in this trial, which carefully adjusts the amount or type of blood pressure medication to achieve a target systolic pressure of 120 millimeters of mercury (mm Hg), reduced rates of cardiovascular events, such as heart attack and heart failure, as well as stroke, by almost a third and the risk of death by almost a quarter, as compared to the target systolic pressure of 140 mm Hg.

The SPRINT study evaluates the benefits of maintaining a new target for systolic blood pressure, the top number in a blood pressure reading, among a group of patients 50 years and older at increased risk for heart disease or who have kidney disease. A systolic pressure of 120 mm Hg, maintained by this more intensive blood pressure intervention, could ultimately help save lives among adults age 50 and older who have a combination of high blood pressure and at least one additional risk factor for heart disease, the investigators say.

The SPRINT study, which began in the fall of 2009, includes more than 9,300 participants age 50 and older, recruited from about 100 medical centers and clinical practices throughout the United States and Puerto Rico. It is the largest study of its kind to date to examine how maintaining systolic blood pressure at a lower than currently recommended level will impact cardiovascular and kidney diseases. NIH stopped the blood pressure intervention earlier than originally planned in order to quickly disseminate the significant preliminary results.

When SPRINT was designed, the well-established clinical guidelines recommended a systolic blood pressure of less than 140 mm Hg for healthy adults and 130 mm Hg for adults with kidney disease or diabetes. Investigators designed SPRINT to determine the potential benefits of achieving systolic blood pressure of less than 120 mm Hg for hypertensive adults 50 years and older who are at risk for developing heart disease or kidney disease.

Between 2010 and 2013, the SPRINT investigators randomly divided the study participants into two groups that differed according to targeted levels of blood pressure control. The standard group received blood pressure medications to achieve a target of less than 140 mm Hg. They received an average of two different blood pressure medications. The intensive treatment group received medications to achieve a target of less than 120 mm Hg and received an average of three medications.

The study is also examining kidney disease, cognitive function, and dementia among the patients; however, those results are still under analysis and are not yet available as additional information will be collected over the next year. The primary results of the trial will be published within the next few months.



  1. 2009年から始まったアメリカ人9300人を対象にした研究「SPRINT」です
  2. 当初は6年間追跡する予定でした
  3. 2010年から2013年に対象者約9250人を2つのグループ(高血圧治療を通常通りに行う群・強力に行う群)に分けました
  4. 通常治療群では目標血圧140mmHg未満、強力治療群では目標血圧120mmHg未満に設定しました
  5. 通常治療群では平均2剤、強力治療群では平均3剤使用することになりました
  6. 強力治療群での冠動脈疾患(心筋梗塞、狭心症)が減少し、十分な効果が見られたので早期に終了します
  7. 数ヶ月以内に主な結果を発表し、来年中は他の結果を収集、解析します




Systolic Blood Pressure Intervention Trial (SPRINT)






NIH says keeping the top number in blood pressure measurement below 120 in people over 50 reduces deaths by 25%
出典:『Study urges more intensive management of high blood pressure』(CNN.com)

The aggressive treatment made a real difference, the researchers said. The risk of a heart attack, stroke, heart failure or other cardiovascular event was one-third lower for the people who aimed for the 120 mm Hg target than it was for the people who aimed for the 140 mm Hg target. In addition, the risk of premature death was nearly 25% lower for volunteers who got the more intensive treatment.
出典:『Aggressive treatment of high blood pressure pays off for patients, study finds』(Los Angeles Times)



大規模に始めた臨床研究で、予定期間よりも早く終わらせていますので、 本当の数字がいくつだったとしても信頼性は高いと思われます。





  • 新しい治療が全く効かない
  • 新しい治療は副作用による死亡が増えている
  • 新しい治療が非常に強い効果がある








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