Pérez GCC, Zavala JLF, Reséndiz BaM

Language: English
References: 12
Page: 329-331
PDF size: 530.30 Kb.

ABSTRACT

The Systolic Blood Pressure Intervention Trial (SPRINT) clinical trial demonstrated that intensive treatment of systolic blood pressure (< 120 mmHg) in older adults is associated with a significant reduction in cardiovascular events and mortality. However, when analyzing the included population and updated results, questions arise regarding the applicability of its conclusions in clinical settings. In this opinion essay, we comment on the SPRINT Senior study, acknowledging the observed benefits while pointing out important limitations such as the exclusion of frail patients, those with multiple comorbidities, or those who are dependent, which restricts the generalizability of the findings to a large proportion of older adults. Moreover, although the study initially reported a 34% reduction in cardiovascular events and a 33% reduction in mortality, the revised 2021 report incorporated additional events, adjusting these results to 27 and 25%, respectively. Additionally, a significant increase in renal impairment was observed in the intensive-treatment group, especially among those without preexisting kidney disease. These findings highlight the need to individualize therapeutic targets in older adults, carefully weighing risks and benefits. We propose a reevaluation of the generalized < 120 mmHg target in this population.

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