Aortic & peripheral vascular disease

Arterial Stiffness Mechanisms and Orthostatic Hypotension in SPRINT: A Randomized Controlled Trial

JACC AdvPublished Systolic Blood Pressure Intervention Trial

Authors' conclusion

Load-dependent stiffness is associated with SAEs, including OH, regardless of BP treatment intensity. Load-dependent PWV may serve as a valuable clinical tool to identify patients who require enhanced surveillance before initiating intensive BP treatment. (Systolic Blood Pressure Intervention Trial SPRINT]; NCT01206062).

Study context

Population
SPRINT participants with carotid-femoral pulse wave velocity (PWV) measured at baselineparticipants with carotid-femoral PWV measured at baseline
Participants
642 participants
Comparison
Intensive (<120 mm Hg) vs standard (<140 mm Hg) systolic blood pressure (BP) goals; association of baseline PWV with orthostatic hypotension (OH) and serious adverse events (SAEs)
Outcome
OH events by load-dependent PWV

Main finding

As reported in the abstract

Higher load-dependent PWV associated with greater numbers of OH events, regardless of treatment group
P = 0.005

Further findings

Higher total PWV associated with greater rates of SAEs
P = 0.001
Largely driven by association with load-dependent PWV
P < 0.001

Safety

Cumulative SAE incidence · 3.0-year median follow-up

OH (most frequent event)

Original publication

Arterial Stiffness Mechanisms and Orthostatic Hypotension in SPRINT: A Randomized Controlled Trial. JACC Adv. Published 11 April 2026. doi:10.1016/j.jacadv.2026.102734

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