It’s “breakthrough” time again. News reports out of the Alzheimer’s Association International Conference (AAIC) this week have been relentlessly upbeat and positive about findings from the NIH’s SPRINT MIND study. The message: aggressive blood pressure control can help protect the brain. But unless you look very carefully at the news reports and “expert” statements you won’t…
No, A Big NIH Trial Did Not Show That Lowering Blood Pressure Will Prevent Dementia
July 26, 2018 by 4 Comments
The Hypertension Guideline War Is Not A Fake War
February 11, 2018 by 14 Comments
The war over the new blood pressure guideline is not a fake war or a childish dispute. It is a real war over genuine differences in how we should think about health and disease and prevention. The publication last November of the new US blood pressure guideline sparked a vigorous and important debate. A central part…
The Survey Says: BP Measurement In SPRINT Was All Over The Place
November 14, 2017 by 1 Comment
–BP measurement question limits the trial’s ability to inform clinical practice. A long-promised report from the SPRINT investigators offers important new information about how blood pressure was monitored in the trial. The report is unlikely to satisfy critics or resolve the larger controversy of how the trial should be interpreted. At the American Heart Association…
New Blood Pressure Guideline Sets Lower 130/80 Threshold
November 13, 2017 by 11 Comments
Expanded guideline means more than 100 million people have high blood pressure. The new US blood pressure guideline lowers the definition of high blood pressure to 130/80 mm Hg. This means that more than 100 million adults will now have high blood pressure, though many will be unaware of the diagnosis. The 192 page guideline…
Aggressive BP Targets Will Hike Falling Risk in Older Patients
July 17, 2017 by 2 Comments
–Another paper raises new questions about applying SPRINT in the real world Applying the intense blood pressure goals used in SPRINT in a real world elderly population might lead to a dramatic increase in injurious falls, according to a new study from Ireland published in JAMA Internal Medicine. The Systolic Blood Pressure Intervention Trial (SPRINT)…
Principal Investigator Defends SPRINT Against Critics
April 20, 2017 by 1 Comment
–Blood pressure experts disagree about the NIH ‘Landmark’ Trial. Since the first announcement of its preliminary results the SPRINT trial has been the focus of intense controversy. One major focus of contention revolves around the precise technique used to measure blood pressure in the trial. As in all recent large outcome trials in hypertension, blood…
Can SPRINT Be Used To Inform Hypertension Treatment?
April 9, 2017 by 3 Comments
–The landmark trial results are not easy to apply to clinical practice. Since the first breathless announcement of its preliminary results, SPRINT trial has been viewed as a landmark trial serving to establish a more aggressive approach to blood pressure management. It is now becoming increasingly clear, however, that the application of SPRINT in the…
New Questions Raised About SPRINT
February 8, 2017 by Leave a Comment
More questions are being raised about SPRINT, the enormous NIH-funded blood pressure lowering trial. Two recent developments will likely add more obstacles to the already difficult task of applying the results of the trial in the real world. Even before the full results of the trial were first made public the NIH and the SPRINT…
SPRINTing to Lower BP Targets? Not So Fast
September 15, 2016 by 2 Comments
–Hypertension experts disagree about how to apply SPRINT results in the real world. Once again blood pressure experts are disagreeing about how to interpret SPRINT and how its results should be applied in the real world. A new study claims that applying the SPRINT results to US patients who meet SPRINT criteria would prevent more…
SPRINT: More Controversy And Confusion About ‘Landmark’ Trial
September 6, 2016 by 3 Comments
–Blood pressure experts raise new questions and concerns about the controversial trial. More questions and concerns are being raised about SPRINT, the NIH’s “landmark” blood pressure lowering trial. In sharp contrast to the enormous amount of initial hype, many hypertension experts are now saying that the SPRINT trial is difficult to interpret and can’t be readily…
Can 50 Million Blood Pressure Prescriptions Each Year Be Wrong?
August 15, 2016 by 2 Comments
–For decades physicians may have been prescribing the wrong diuretic. Now an innovative new trial will settle the question. A radically innovative large new VA trial will finally shed light on a decades-old unresolved question that could have important public health implications. According to guidelines thiazide diuretics are the first-line treatment for hypertension. Hydrochlorothiazide accounts…
How Does HOPE-3 Change Thinking About Primary Prevention?
April 2, 2016 by 5 Comments
–The study lends strong support for statins but delivers a mixed message for antihypertensives. The widely reported results of HOPE-3 may bolster the case for primary prevention with statins and blood pressure drugs. But the trial also makes clear that the benefits, though real, are also modest, and may not be evenly distributed between statins…
Best Selling Smartphone Blood Pressure App Gave Wrong Results
March 2, 2016 by Leave a Comment
A best-selling smartphone app that purported to measure blood pressure actually delivered highly inaccurate results, according to a research letter in JAMA Internal Medicine. The finding could cause genuine medical harm for the large number of people who use the app. In addition, the study adds new fuel to the fiery debate about the reliability…
Slow Down. Don’t Sprint To More Aggressive BP Treatment
February 22, 2016 by 7 Comments
Two editorialists in Annals of Internal Medicine urge caution in interpreting and adopting the findings of the SPRINT (Systolic Blood Pressure Intervention Trial), which last year showed a benefit for a more aggressive approach to blood pressure therapy. The trial found improved outcomes in high risk patients treated to a target of of 120 mm…
Study Shows Why Sham Controls Are Necessary For Device Trials
January 12, 2016 by 1 Comment
— If we can melt the ice-caps then surely we can understand our own fallibility, says one UK cardiologist. The strongest known force in the universe is the ability of the human mind to deceive itself. If we know something to be true then we find the evidence to prove it. There is no better…
Meta-Analysis Gives More Support To Aggressive Blood Pressure Treatment
December 23, 2015 by 1 Comment
A large new meta-analysis offers fresh support to the growing movement in favor of more aggressive treatment to lower high blood pressure. The findings are consistent with and extend the results of the recently reported NIH SPRINT trial, which found substantial clinical benefits for a systolic blood pressure target of 120 mm Hg instead of 140…
Lancet Sprints To The Front With A Blood Pressure Meta-Analysis
November 6, 2015 by 1 Comment
A new meta-analysis published in the Lancet on Friday lends fresh support to calls for more intensive blood pressure treatments. The publication comes only days before the highly anticipated presentation of the NIH’s SPRINT trial at the American Heart Association, which is also expected to offer support for stricter blood pressure control. Blood pressure goals were relaxed after the ACCORD…
Coming Attraction: Looking Forward To SPRINT At The AHA Next Month
October 27, 2015 by Leave a Comment
Back in September the NIH tantalized the medical community with a preliminary announcement of the results of a major clinical trial, SPRINT (Systolic Blood Pressure Intervention Trial). The NIH said SPRINT was a “landmark trial” that could “save lives,” but their claims were impossible to evaluate since they only gave the slightest hint of the actual results. On November…
Heart Failure Experts SPRINT To An Early Finish
October 7, 2015 by Leave a Comment
According to a recent news report a group of prominent heart failure doctors have eagerly embraced a lower blood pressure target of 120 mm Hg for heart failure patients based on the preliminary results of the SPRINT trial announced last month. But another equally prominent heart failure doctor says that it is far too early to…
SPRINT Trial To Be Presented At The American Heart Association Meeting In November
September 29, 2015 by Leave a Comment
Update: I have now received confirmation that SPRINT will be presented on Monday, November 9 at 2 PM. The SPRINT trial, which provoked a storm of excitement and controversy a few weeks ago, will be presented in November at the American Heart Association meeting in Orlando. The trial is not currently on the list of late-breaking clinical trials but…
A Premature SPRINT To The Finish Line
September 14, 2015 by 1 Comment
On Friday the NHLBI declared victory in the SPRINT trial. As was widely reported here and elsewhere, the NHLBI announced that the trial had been stopped early after significant reductions in cardiovascular events and mortality had occurred in the group of hypertensive patients randomized to a more aggressive blood pressure target than is currently recommended today. But there was a…
NIH Trial, Stopped Early, Supports More Intensive Blood Pressure Targets
September 11, 2015 by Leave a Comment
More stringent blood pressure targets could save lives and reduce cardiovascular events, according to preliminary results from a large NIH clinical trial that was stopped early. The SPRINT (Systolic Blood Pressure Intervention Trial) trial randomized 9,361 hypertensive patients 50 years of age or older to the standard systolic blood pressure target (when the trial began) of 140…
Another Study Raises Questions About Blood Pressure Guidelines
February 10, 2015 by Leave a Comment
Although the general benefits of lowering high blood pressure are widely accepted, there has been intense debate over specific goals for treatment and the threshold at which therapy should be initiated. A large new meta-analsysis published in JAMA helps shed lights on this important controversy. UK and Australian researchers analyzed the effect of lowering blood pressure in people…
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