Achieving Intensive Blood Pressure Control in High-Risk Patients: Implementation Insights From the ESPRIT 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
| Group | Value | Achieving intensive BP control | Median time to intensive control | Medication equivalent at 1 year | Clinic visit frequency, first year |
|---|---|---|---|---|---|
| Intensive | median 117 (IQR 113-123 mm Hg) mm Hg | 62.5% | 62 days (IQR: 33-96 days) | 3.3 | 6.9 |
| Standard | 2.0 | 5.4 |
Value
Intensivemedian 117 (IQR 113-123 mm Hg) mm Hg
StandardNot reported in the abstract
Achieving intensive BP control
Intensive62.5%
StandardNot reported in the abstract
Median time to intensive control
Intensive62 days (IQR: 33-96 days)
StandardNot reported in the abstract
Medication equivalent at 1 year
Intensive3.3
Standard2.0
Clinic visit frequency, first year
Intensive6.9
Standard5.4
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: Implementation Insights From the ESPRIT Trial. J Am Coll Cardiol. Published 1 April 2026. doi:10.
Summarised from the published abstract; every number is checked against it