Targeting the Efficacy of Intensive Blood Pressure Treatment in Hypertensive Patients　― An Exploratory Analysis of SPRINT ―

Abstract

adjusted life years annually. Although antihypertension treatment reduces the incidence of major adverse cardiovascular events (MACEs), a substantial proportion of treated patients still have uncontrolled BP. 9,10 Most importantly, the optimal BP treatment target remains controversial due to discordant findings from the latest observational studies and randomized controlled trials (RCTs). 11The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated the benefits of an intensive SBP treatment target (<120 mmHg) vs. a standard target (<140 mmHg) in reducing cardiovascular events and all-cause death in adults without diabetes. 12 However, other studies have reported no benefit or increased risk of CVD death. [13][14][15] The Action to Control Cardiovascular Risk in Diabetes H ypertension (HTN) is the leading preventable cause of cardiovascular disease (CVD), chronic kidney disease (CKD) and dementia. 1-3 With population aging, severe COVID-19 complications, 4 and worsening trends in HTN control, 5 the health burden of HTN will remain a global social challenge worldwide. In 2015, the number of all-cause deaths attributable to systolic blood pressure (SBP) ≥140 mmHg was estimated at 7.8 million (14.0% of all deaths) and the number for SBP ≥110-115 mmHg was 10.7 million (19.2% of all deaths). 6,7 According to the Global Burden of Disease Study, 8 nonoptimal BP has been and continues to be the most prominent risk factor for disease and all-cause deaths globally, resulting in 9.4 million deaths and 212 million disability-