Intensive vs Standard Blood Pressure Control in Adults 80Years or Older: A Secondary Analysis of the Systolic Blood Pressure Intervention Trial

OBJECTIVESTo evaluate the effect of intensive systolic blood pressure (SBP) control in older adults with hypertension, considering cognitive and physical function.DESIGNSecondary analysis.SETTINGSystolic Blood Pressure Intervention Trial (SPRINT)PARTICIPANTSAdults 80 years or older.INTERVENTIONParticipants with hypertension but without diabetes (N = 1167) were randomized to an SBP target below 120 mm Hg (intensive treatment) vs a target below 140 mm Hg (standard treatment).MEASUREMENTSWe measured the incidence of cardiovascular disease (CVD), mortality, changes in renal function, mild cognitive impairment (MCI), probable dementia, and serious adverse events. Gait speed was assessed via a 4‐m walk test, and the Montreal Cognitive Assessment (MoCA) was used to quantify baseline cognitive function.RESULTSIntensive treatment led to significant reductions in cardiovascular events (hazard ratio [HR] = .66; 95% confidence interval [CI] = .49‐.90), mortality (HR = .67; 95% CI = .48‐.93), and MCI (HR = .70; 95% CI = .51‐.96). There was a significant interaction (P