Molsberry RJ, Rethy L, Wang MC, et al. - Greater effectiveness of intensive blood pressure (BP) lowering (target<120 mm Hg) in preventing heart failure (HF), vs standard BP goals (target<140 mm Hg), has been reported in the SPRINT (Systolic Blood Pressure Intervention Trial). In this study of SPRINT participants without prevalent cardiovascular disease, it was revealed that the high burden of HF in the United States could be attenuated by prioritizing intensive BP lowering in those carrying the highest predicted HF risk.

• Depending on the predicted HF risk, SPRINT participants without prevalent cardiovascular disease were divided into HF risk tertiles.

• This analysis involved 6,911 persons, and a median follow-up of 3.3 years recorded occurrence of 77 incident HF events.

• Participants randomized to intensive BP lowering showed decrease in HF risk in each risk tertile but such risk reduction was significant only in the highest HF risk category (risk tertile 1: hazard ratio, 0.86; risk tertile 2: 0.54; risk tertile 3: 0.46).

• In all groups, frequent occurrence of serious adverse events was observed.

• Short follow-up could result in an underestimation of benefit in the lower predicted risk groups.