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November 2016

Comparing the SPRINT and the HOPE-3 Blood Pressure Trial

Author Affiliations
  • 1Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
  • 2Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
  • 3Clinical Applications and Prevention Branch, Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
JAMA Cardiol. 2016;1(8):855-856. doi:10.1001/jamacardio.2016.2051

In 2015 and 2016, respectively, the Systolic Blood Pressure Intervention Trial (SPRINT) and Heart Outcomes Prevention Evaluation (HOPE)–3 blood pressure (BP) trial published different conclusions.1,2 In SPRINT, more intensive BP reduction than is recommended resulted in a 25% reduction for the primary outcome, a composite based on first occurrence of nonfatal myocardial infarction, non–myocardial infarction acute coronary syndrome, stroke, acute decompensated heart failure, or cardiovascular disease (CVD) death.1 In addition, all-cause mortality was reduced by 27%. The SPRINT findings led to stopping the trial early. In HOPE-3, BP lowering had no significant effect on either of the 2 coprimary CVD composite outcomes (MI, stroke, or CVD death and these plus resuscitated cardiac arrest, HF, and revascularization).2