Generalizability of the SPRINT Results

Summary and Comment |
November 9, 2015

Generalizability of the SPRINT Results

  1. Harlan M. Krumholz, MD, SM

An analysis of NHANES data shows how many U.S. adults with hypertension meet SPRINT eligibility criteria.

  1. Harlan M. Krumholz, MD, SM

The SPRINT trial (N Engl J Med 2015 Nov 9; [e-pub]), which tested a blood pressure goal of <120 mm Hg against the standard goal of <140 mm Hg, was released amid much fanfare, but a relevant question is its generalizability. Non-SPRINT investigators used data from the National Health and Nutrition Examination Survey to estimate the prevalence, number, and characteristics of U.S. adults who would meet SPRINT inclusion criteria.

They found that in the years 2007–2012, an estimated 7.6% of U.S. adults (17 million people) — including 16.7% of those with treated hypertension (8 million) and 5.0% of those not being treated (8.5 million) — met SPRINT eligibility criteria. Among all U.S. adults with hypertension, an estimated 20% met eligibility criteria.


Many Americans meet SPRINT eligibility criteria and might benefit from the blood pressure goal of <120 mm Hg. However, importantly, 5 of 6 people with treated hypertension do not meet the eligibility criteria. Decisions about treatment goals for these patients will be based on greater uncertainty than for the patients who meet the eligibility criteria.

Note to readers: At the time NEJM Journal Watch reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

Editor Disclosures at Time of Publication

  • Disclosures for Harlan M. Krumholz, MD, SM at time of publication Consultant / Advisory board United Healthcare; VHA, Inc.; Premier, Inc. Equity ImageCor; Me2Health Grant / Research support FDA; NIH-NHLBI; Commonwealth Fund; The Catherine and Patrick Weldon Donaghue Medical Research Foundation; Robert Wood Johnson Foundation; Medtronic; Johnson and Johnson; Chinese National Center for Cardiovascular Disease; FDA; CMS Editorial boards; American Journal of Managed Care; American Journal of Medicine; Archives of Medical Science; Central European Journal of Medicine; Critical Pathways in Cardiology; Current Cardiovascular Risk Reports; JACC: Cardiovascular Imaging; Journal of Cardiovascular Medicine; Circulation: Cardiovascular Quality and Outcomes Leadership positions in professional societies American Board of Internal Medicine (Chair, Assessment 2020 Task Force)


Reader Comments (2)

JYOTI BAJPAI Fellow-In-Training, Pulmonary Medicine, university hospital

in case of patients with multiple comorbidities a tighter BP goal may harm like accord & advance

WILLIAM DURICK Physician, Geriatrics

This number goal may not be appropriate for older patients with risks of falls and even hypotension in some patients. Patient care must be individualized particularly in the elderly.

Your Comment

(will not be published)

Filtered HTML

  • Allowed HTML tags: <a> <em> <strong> <cite> <blockquote> <code> <ul> <ol> <li> <dl> <dt> <dd>
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Do you have any conflict of interest to disclose?
This question is for testing whether you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

* Required

Reader comments are intended to encourage lively discussion of clinical topics with your peers in the medical community. We ask that you keep your remarks to a reasonable length, and we reserve the right to withhold publication of remarks that do not meet this standard.

PRIVACY: We will not use your email address, submitted for a comment, for any other purpose nor sell, rent, or share your e-mail address with any third parties. Please see our Privacy Policy.