Abstract 047: Clinical Outcomes by Race and Ethnicity in the Systolic Blood Pressure Intervention Trials (SPRINT): A Randomized Control Trial

Abstract

Background: Lowering systolic blood pressure (SBP) reduces cardiovascular disease morbidity and mortality; however, appropriate SBP targets, especially by race/ethnicity remain uncertain. Methods and Results: We examined the effects of an intensive SBP goal (<120 mm Hg) compared to the current recommendation (< 140 mmHg) on cardiovascular disease (CVD) outcomes in racial-ethnic groups in SPRINT (Systolic Blood Pressure Intervention Trial). High-risk non-diabetic patients with hypertension (N = 9,361; 30% Black; 11% Hispanic), 50 years and older were enrolled at 102 clinical sites across the U.S. and Puerto Rico. Primary outcome was a composite of the first occurrence of a myocardial infarction, acute coronary syndrome, stroke, decompensated heart failure, or CVD death. Average ± SD post-baseline SBP across race/ethnic groups ranged from 134.7±0.1 to 135.5±0.2 mmHg in the standard arm compared to 119.9±0.4 to 122.6±0.2 in the intensive arm. Intensive vs. standard arm hazard ratios [HRs] (95% CI) for the primary outcome were 0.70 (0.57-0.86), 0.71 (0.51-0.98), 0.62 (0.33-1.15) in Non-Hispanic Whites, Non-Hispanic Blacks, and Hispanics respectively. CVD mortality HRs were 0.49 (0.29-0.81), 0.77 (0.37-1.57), and 0.17 (0.01-1.08) with all-cause mortality HRs 0.61 (0.47-0.80), 0.92 (0.63-1.35), and 1.58 (0.73-3.62). Tests for interaction were not statistically significant after adjustment for multiple comparisons. Conclusion: Regardless of racial/ethnic origin, there are cardiovascular benefits from treating to a SBP target of < 120 mmHg compared to <140 mmHg.