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HypertensionSecondary analysis

Using PREVENT Equations to Compare Intensive vs Standard Systolic Blood Pressure Control for Primary Prevention in SPRINT

J Am Coll CardiolPublished

  • Secondary analysis of the SPRINT randomised trial
  • analysis by PREVENT 10-year total cardiovascular disease (CVD) risk strata
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Authors' conclusion

Among SPRINT participants without baseline CVD, the relative risk reduction with intensive vs standard SBP treatment was consistent across PREVENT risk strata. However, the absolute risks varied several-fold from the low- or borderline-risk group to the high-risk group.

Study context

Population
SPRINT participants without prevalent CVD, with complete data for baseline PREVENT 10-year total CVD riskanalysed
Participants
6,554 participants
Comparison
Intensive vs standard systolic blood pressure (SBP) treatment
Primary endpoint
Primary composite outcome:
  • MI
  • ACS
  • Stroke
  • HF
  • CVD death

Primary result

As reported in the abstract

Primary composite outcome, by PREVENT 10-year total CVD risk stratum · median follow-up 3.86 years
Intensive vs StandardHazard ratio (95% CI)
low or borderline risk (<7.5%)
0.74(0.33–1.66)
intermediate risk (7.5% to <20%)
0.70(0.52–0.93)
high risk (≥20%)
0.85(0.60–1.20)
4-year absolute risk difference, low or borderline risk
0.002
4-year absolute risk difference, intermediate risk
0.015
4-year absolute risk difference, high risk
0.024

Further findings

Baseline PREVENT 10-year total CVD risk

Median PREVENT 10-year risk for total CVD
13% (Q1-Q3: 9%-19%)
Low or borderline / intermediate / high risk
16%, 62%, and 22%

Safety

OutcomeHR (95% CI)
Serious adverse events by PREVENT risk stratum — Intensive vs Standard · low or borderline risk1.12 (0.53–2.38)
Serious adverse events by PREVENT risk stratum — Intensive vs Standard · intermediate risk1.66 (1.24–2.24)
Serious adverse events by PREVENT risk stratum — Intensive vs Standard · high risk1.28 (0.87–1.87)
  • Serious adverse events by PREVENT risk stratum: interaction P = 0.44

Original publication

Using PREVENT Equations to Compare Intensive vs Standard Systolic Blood Pressure Control for Primary Prevention in SPRINT. J Am Coll Cardiol. Published 28 October 2025. doi:10.1016/j.jacc.2025.07.037
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Summarised from the published abstract; every number is checked against it