HypertensionSecondary analysis

Achieving Intensive Blood Pressure Control in High-Risk Patients

J Am Coll CardiolPublished

  • Secondary analysis of the ESPRIT randomised trial

Authors' conclusion

For the diverse hypertensive patients with high cardiovascular risk, including those with longstanding uncontrolled BP, sustaining SBP <120 mm Hg is achievable with modest additional medical resources.

Study context

Population
Hypertensive patients with high CV risk, including longstanding uncontrolled blood pressure (BP)
Participants
11,255 patients
Comparison
Intensive vs standard BP control
Primary endpoint
Implementation of targeting SBP <120 mm Hg (achieved BP, time to intensive control, medication use, clinic visits) and effect heterogeneity

Primary result

As reported in the abstract

Implementation of intensive SBP control
GroupValueAchieving intensive BP controlMedian time to intensive controlMedication equivalent at 1 yearClinic visit frequency, first year
Intensivemedian 117 (IQR 113-123 mm Hg) mm Hg62.5%62 days (IQR: 33-96 days)3.36.9
Standard2.05.4

Further findings

Treatment effect by hypertension duration and baseline systolic BP (SBP) combination (subgroups)

Except MI: P for interaction
0.019
No significant interaction (all P for interaction > 0.05)

Original publication

Achieving Intensive Blood Pressure Control in High-Risk Patients. J Am Coll Cardiol. Published 1 April 2026. doi:10.1016/j.jacc.2026.01.083

Summarised from the published abstract; every number is checked against it