Tufts Medical Center researchers, clinicians and patients were involved in a national research study which produced important findings that may have a major future impact on how physicians treat high blood pressure. Strong preliminary results of the Systolic Blood Pressure Intervention Trial (SPRINT) showed significantly better outcomes – an overall 30 percent reduction in the risk of cardiovascular disease events and a much lower risk of death - for patients whose blood pressure was well below the current recommended standard. Given these impressive results, the intervention portion of SPRINT ended on September 11, 2015, a year earlier than planned.
Nephrologist Daniel Weiner, MD was the site principal investigator (PI) at Tufts Medical Center; Tufts MC was the largest SPRINT site in New England and the only site in Boston, with 105 patients recruited to participate in the five-year study. SPRINT followed more than 9,000 people across the United States to determine whether targeting a systolic blood pressure reading below 120 mm Hg reduces the risk of cardiovascular disease in high risk adults with hypertension. It was among the largest ongoing federally funded trials in the U.S.
The success at Tufts MC was due to collaborative effort between clinical and research teams. Patients were recruited through Tufts MC Primary Care (formerly General Medical Associates) and the Kidney and Blood Pressure Center at Tufts MC, as well as from physicians in the greater Boston community who encouraged their patients to enroll. Primary Care physicians used the electronic medical record to develop lists of their patients who were good candidates for the trial, then informed these patients about the study. That direct outreach from a familiar, trusted doctor, helped to boost enrollment numbers and enhanced communications among the study team, the primary care physician and the participating patient for the duration of the trial. During the five-year study period, only one patient recruited by Tufts MC stopped participating.
Potentially Game Changing Results
SPRINT investigators found much lower incidences of cardiovascular disease and death in the group of patients in which they targeted a systolic blood reading less than 120 mm Hg, as compared to less than 140 mm Hg, the current standard recommendation for systolic blood pressure control in adults. Treatment of all patients in the study involved commonly used, widely available affordable medications.
The SPRINT results are greatly encouraging and potentially groundbreaking, as about one-third of U.S. adults have high blood pressure, placing them at risk for heart attacks, strokes, heart failure, kidney disease and other health problems.
More Research Still to be Done
Dr. Weiner cautions that the exciting results still require further analysis, including the impact of a more intensive blood pressure target on kidney function, quality of life, potential side effects and cognitive function. The results also are subject to peer review and an assessment of patient populations for which more intensive systolic blood pressure targets may not be appropriate.
“The SPRINT study may well be a landmark moment for treatment of hypertension and reducing risk of cardiovascular problems and disease. Everyone involved is looking forward to the peer review process,” Dr. Weiner said. “I’m especially satisfied that Tufts MC played such a critical role in this study, and through collaboration between researchers and clinicians, we recruited a significant patient population to participate and contribute to these important findings.”