This a change from the old guideline definition for high blood pressure, which was systolic readings of 140 mm Hg or higher or diastolic readings of 80 mm Hg or higher. The guidelines define high blood pressure for adults as systolic readings of 130 mm Hg or higher or diastolic readings of 80 mm Hg or higher. SPRINT and other clinical research findings informed these new ACC/AHA guidelines, which were published in the Journal of American College of Cardiology and Hypertension. In November 2017, the American College of Cardiology (ACC) and the American Heart Association (AHA) released new comprehensive high blood pressure guidelines. population age 75 and older have high blood pressure. This was an important finding because a large percentage of the U.S. SPRINT included a large group of adults age 75 and older, and a separate analysis confirmed that treating to a lower blood pressure target reduced complications of high blood pressure and saved lives in older adults, as with the overall study population, even for older study participants who had poorer overall health. Overall, the benefits in reducing the risk of cardiovascular disease and death outweighed the potential side effects of treating to a lower blood pressure target. Treating to the target systolic blood pressure of less than 120 mm Hg also showed an increase in complications due to low blood pressure such as fainting however, there was not an increased risk of falls. In the lower blood pressure group, there were expected side effects from blood pressure medicines, such as lower blood levels of potassium and sodium. Participants had high levels of satisfaction with treatment and adherence to medicines regardless of which treatment group they were in. The second treatment group received two medicines to treat to the target systolic blood pressure of less than 140 mm Hg. To achieve the target systolic blood pressure of less than 120 mm Hg, the first treatment group received three medicines on average. The cardiovascular benefits of the lower systolic blood pressure target were consistent in all groups of people included in SPRINT, regardless of gender, race, age, or pre-existing CKD. In 2015, the SPRINT Research Group published its findings in the New England Journal of Medicine. Compared with the standard target systolic pressure of 140 mm Hg, treating to less than 120 mm Hg also lowered the risk of death by 27 percent. In adults age 50 and older who had high blood pressure and at least one additional cardiovascular disease risk factor, but who had no history of diabetes or stroke, SPRINT showed that treating to a target systolic blood pressure of less than 120 mm Hg reduced rates of high blood pressure complications, such as heart attack, heart failure, and stroke, by 25 percent. Brain: SPRINT Memory and Cognition IN Decreased Hypertension (SPRINT-MIND) is examining whether treating to the lower blood pressure target reduces the risk of developing dementia, slows the decline in cognitive function, and results in less small vessel disease in the brain as shown by magnetic resonance imaging (MRI).Kidneys: SPRINT recruited a group of participants who had chronic kidney disease to see how the lower systolic blood pressure target affected their cardiovascular and kidney function. But the benefits and potential side effects of treating people who had no history of diabetes or stroke to a systolic blood pressure of less than 120 mm Hg, as compared to treating to less than 140 mm Hg, had not been tested in a long-term clinical trial. When SPRINT was designed, observational studies showed that participants with lower systolic blood pressure levels had fewer complications and deaths due to cardiovascular diseases. Cardiovascular: The main cardiovascular research question in SPRINT was to understand whether treating high blood pressure to a target systolic blood pressure goal of less than 120 mm Hg was better than treating to a goal of less than 140 mm Hg, which was the commonly recommended target at the time the SPRINT study was initiated.The NIH Systolic Blood Pressure Intervention Trial (SPRINT), an NHLBI-supported study, was designed to answer three important research questions about how treating to a lower systolic blood pressure target-less than 120 millimeters of mercury (mm Hg)-affects the cardiovascular system, kidneys, and brain. High blood pressure is a major public health concern because it is a very common condition and a leading risk factor for other conditions, including heart attack, heart failure, stroke, chronic kidney disease, and cognitive decline.
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