Intensive blood-pressure control (SPRINT)
In the SPRINT trial, targeting systolic blood pressure below 120 mm Hg rather than below 140 reduced cardiovascular events in high-risk adults without diabetes.
What the study found
The best systolic blood-pressure target had been uncertain. SPRINT (New England Journal of Medicine, 2015) randomly assigned 9,361 adults with a systolic pressure of 130 mm Hg or higher and increased cardiovascular risk, but without diabetes, to an intensive target of less than 120 mm Hg or a standard target of less than 140. At one year, mean systolic pressure was 121.4 mm Hg in the intensive group versus 136.2 in the standard group. The primary composite outcome — heart attack, other acute coronary syndromes, stroke, heart failure, or cardiovascular death — occurred less often with intensive control, and the trial was stopped early.
Why it matters
High blood pressure is a leading, modifiable driver of heart and vascular disease. Showing that a lower target further reduced hard cardiovascular outcomes in a large randomized trial influenced how aggressively blood pressure is treated in higher-risk patients.
Analysis — the pattern
This is a "how low to go" question (analysis, not a single-study claim): the answer depends on who is treated. SPRINT enrolled higher-risk adults without diabetes, and its benefit came with more of certain side effects, such as low blood pressure and kidney-function changes — a reminder that a target trades benefit against harm.
What is still uncertain
Results may not transfer to people the trial excluded, such as those with diabetes or prior stroke, and blood-pressure measurement methods affect the numbers. The right target for each individual, balanced against side effects, remains a clinical judgment.