UT Health Science Center Has Role in Landmark National Blood Pressure Study

When researchers released the findings of a national blood pressure study showing that aggressive intervention to lower systolic blood pressure in older adults below conventional standards reduces cardiovascular disease, stroke and death, it wasn’t news to Memphis landscape company owner Joe Pipkin.

A five-year participant in the Memphis site of the landmark Systolic Blood Pressure Intervention Trial (SPRINT), Pipkin says he feels great, thanks to the SPRINT study team members at the University of Tennessee Health Science Center (UTHSC). They worked with him to reduce his systolic blood pressure from about 140 to under 120, through a carefully monitored regimen of medication. “It has been super great for me,” said Pipkin, 59. “My energy levels are good, my outlook has improved. I’m very happy about it.”

This month, the world learned about similar results for other participants in the study. Those results are expected to change the way blood pressure is treated globally in the future.

Details of the SPRINT study were released on November 9 at the American Heart Association (AHA) conference in Orlando, Florida, and published online in the New England Journal of Medicine. They reported that more intensive management of high blood pressure, below the commonly recommended blood pressure target, markedly reduces rates of cardiovascular disease, and lowers risk of death in a group of adults 50 years and older with high blood pressure.

The intervention in this randomized clinical trial carefully adjusted the amount or type of blood pressure medication to achieve a target systolic pressure reading of less than 120, reducing rates of cardiovascular events, such as heart attack and heart failure, as well as stroke, by 25 percent, and the risk of death by 27 percent, compared to the traditional target systolic pressure of less than 140. Systolic blood pressure is the top number in a blood pressure reading.

With the National Heart, Lung, and Blood Institute (NHLBI), a unit of the National Institutes of Health (NIH), as its primary sponsor, the SPRINT study started in the fall of 2009, and included more than 9,300 participants age 50 and older who were recruited from about 100 medical centers and clinical practices throughout the United States and Puerto Rico.

In Memphis, the Department of Preventive Medicine at UTHSC was a large SPRINT study site, following 175 participants since the study launched. The Memphis Veterans Affairs Medical Center enrolled 80 participants.

Dr. Karen C. Johnson

UTHSC scientist Karen C. Johnson, MD, MPH, was the principal investigator for the local SPRINT study site. Dr. Johnson, a professor in the Department of Preventive Medicine and College of Medicine Endowed Professor in Women’s Health, is also the national vice chair of the SPRINT Steering Committee and one of the authors of the report.

Originally, the SPRINT study was supposed to continue into the fall of 2016, but on September 11, 2015, the NHLBI announced it had stopped the study in order to quickly disseminate the preliminary results. The reasons for halting SPRINT were positive, and preliminary results were released early because they had the potential to help many with high blood pressure.

Since the SPRINT study population included women, racial and ethnic minorities, and the elderly, there is significant scientific support for the application of its findings across a broad population.

High blood pressure – hypertension — affects one in every three American adults, nearly 80.7 million people, according to the AHA. Hypertension is an important risk factor for heart disease and stroke, the first and third leading causes of death in the United States. It is also a contributing risk factor for chronic kidney disease and cognitive function decline.

Hypertension is a serious health burden among Memphis-area residents and Tennesseans. The Tennessee Department of Health states almost 34 percent of all adult Tennesseans were diagnosed with high blood pressure. Furthermore, African-Americans are more likely to develop high blood pressure.

“The results of the SPRINT study have far-reaching implications to help the Memphis and Mid-South community prevent disease and extend healthy life,” Dr. Johnson said. “The next steps will include quickly communicating the SPRINT results to help inform patient care and the future development of evidence-based clinical guidelines.”

The SPRINT study was also assessing the impact of intensive blood pressure reduction on the risk for Alzheimer’s disease and other forms of dementia, as well as examining kidney disease among the study participants. These results are not yet available.

Besides the NHLBI, SPRINT is co-sponsored by the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and the National Institute on Aging.

Pipkin can’t recall exactly how he learned about the study. He thinks his wife, Ramona Pipkin, chairman’s assistant and administrative coordinator in the UTHSC Department of Surgery, may have mentioned it. In any case, he’s glad he participated. “I would have high blood pressure pretty regularly to the point my face got red and it literally felt like it was going to pop,” he said. “I was starting to feel sluggish and a bit down. I have been an athlete most of my life, and that was the key for me to find some kind of help.”

He now takes potassium and three medicines to manage his blood pressure. That took some getting used to, he said. But over time, his medication has been reduced, and he’s been told that at some point he might not require medication at all.

“If your blood pressure is elevated, that’s certainly a dangerous thing,” he said. “Going through this program has been very helpful, not only monitoring my blood pressure, but getting it to a healthy level. The whole thing about it is, I feel good.”

SPRINT at a Glance

  • Started 2009; ended 2015
  • More than 9,300 participants age 50 and older enrolled
  • Traditional systolic blood pressure target: 140
  • Intensive treatment target: 120 or less, achieved through carefully monitored medication regimen.
  • Findings: Lower target reduced cardiovascular events and stroke by 25 percent and risk of death by 27 percent.