. 2023 Oct 17;330(15):1459–1471. doi: 10.1001/jama.2023.18497

Table 1. Characteristics of Included Trials.

Source	Demographic characteristics	Key conditions	BP eligibility requirements, mm Hg	More intensive BP treatment assignment	Less intensive BP treatment assignment	BP measurement	Length of follow-up, median, y	Definition of cardiovascular disease event or all-cause mortality
BP treatment goal trials
AASK (n = 1094)¹⁸	African American patients aged 18-70 y	Hypertensive kidney disease without diabetes	Seated DBP ≥95	Goal: MAP ≤92 mm Hg Agents: 1 of 3 first-line agents, metoprolol (50-200 mg/d), ramipril (2.5-10 mg/d), or amlodipine (5-10 mg/d)	Goal: MAP of 102-107 mm Hg	Seated: mean of the last 2 of 3 measures Standing: 1 measure after 2:45 min of standing	CVD or all-cause mortality: 3.8 All-cause mortality: 4.1	Any definite or probable cardiovascular outcomes (nonfatal myocardial infarction, stroke, heart failure) or death due to any cause
ACCORD BP (n = 4733)¹⁹	Patients aged ≥40 y	Diabetes, CVD, or CVD risk factors	Seated SBP 130-180^a	Goal: SBP <120 mm Hg Agents: First-line agent a combination of diuretic and either ACE inhibitor or β-blocker	Goal: SBP <140 mm Hg	Seated: mean of 3 measures Standing: mean of 3 measures, 1 min after standing, each measure separated by 1 min	CVD or all-cause mortality: 4.0 All-cause mortality: 4.0	Primary end point (nonfatal myocardial infarction, nonfatal stroke, or death due to cardiovascular causes), nonfatal heart failure, or death due to any cause
SPRINT (n = 9361)¹⁶	Patients aged ≥50 y	High risk for CVD without prior stroke or diabetes	Seated SBP 130-180^a and standing SBP <110	Goal: SBP <120 mm Hg Agents: Thiazide-type diuretic encouraged, loop diuretics (advanced chronic kidney disease), and β-blockers (coronary artery disease). Chlorthalidone was encouraged as the primary thiazide-type diuretic and amlodipine as the preferred calcium channel blocker	Goal: SBP <140 mm Hg	Seated: mean of 3 measures Standing: 1 measure, 1 min after standing	CVD or all-cause mortality: 3.8 All-cause mortality: 3.8	Primary end point (myocardial infarction, acute coronary syndrome, stroke, heart failure, or death due to cardiovascular causes) or death due to any cause
SPS3 (n = 3020)²⁰	Patients aged ≥30 y	Recent lacunar stroke and hypertension	Seated SBP ≥140 or seated DBP ≥90	Goal: SBP <130 mm Hg Agents: clinician-directed regimen	Goal: SBP 130-149 mm Hg	Seated: mean of 3 measures Standing: 1 measure, 2 min after standing	CVD or all-cause mortality: 3.0 All-cause mortality: 3.2	Primary end point (recurrent fatal and nonfatal stroke) or acute myocardial infarction, heart failure event, or death due to any cause
UKPDS (n = 1148)¹⁵	Patients aged 25-65 y	Diabetes and hypertension	Seated SBP ≥150 or seated DBP ≥85 (≥160/≥85 if taking medication for hypertension)	Goal: BP <150/85 mm Hg Agents: captopril (25 mg/d to 50 mg twice daily) or atenolol (50-100 mg/d) as first-line agent	Goal: BP <180/105 mm Hg	Seated: mean of last 3 of 4 measures^b Standing: 1 measure 1 min after standing	CVD or all-cause mortality: 8.1 All-cause mortality: 8.6	Any myocardial infarction, any stroke, any heart failure, or death due to any cause
Placebo-controlled trials
HYVET (n = 3845)¹⁷	Patients aged ≥80 y	Hypertension	Seated SBP 160-199, standing SBP ≥140, seated DBP 90-109^c	Goal: <150/80 mm Hg Agents: indapamide sustained release (1.5 mg/d) (first line)	Placebo	Seated: mean of 2 measures Standing: mean of 2 measures after 2 min of standing	CVD or all-cause mortality: 5.9 All-cause mortality: 5.9	Primary end point (fatal or nonfatal stroke), any myocardial infarction, any heart failure, or death due to any cause
SHEP (n = 4736)²¹	Patients aged ≥60 y	Isolated systolic hypertension	Seated SBP 160-219,^d standing SBP ≥140, seated DBP <90	Goal: if baseline SBP >180 mm Hg, goal was SBP <160 mm Hg; if baseline SBP 160-179 mm Hg, goal was 20–mm Hg reduction Agents: step 1: chlorthalidone (12.5-25 mg/d); step 2: atenolol (25-50 mg/d) or reserpine (0.05-0.1 mg/d)	Placebo	Seated: mean of 2 measures Standing: 2 measurements after 1 and 3 min of standing	CVD or all-cause mortality: 4.2 All-cause mortality: 4.3	Any stroke, any coronary heart disease, any left ventricular heart failure, or death due to any cause
SYST-EUR (n = 4695)²²	Patients aged ≥60 y	Isolated systolic hypertension	Seated SBP <220, standing SBP ≥140, seated DBP <95	Goal: SBP <150 mm Hg (reduction of ≥20 mm Hg) Agents: nitrendipine (10 mg/d to 20 mg twice daily) combined with or replaced by enalapril (5-20 mg/d), hydrochlorothiazide (12.5-25 mg/d), or both	Placebo	Seated: mean of 2 measures Standing: 2 measures after 2 min of standing	CVD or all-cause mortality: 1.9 All-cause mortality: 2.0	Nonfatal myocardial infarction, nonfatal stroke, nonfatal heart failure, or death due to any cause
TOMHS (n = 902)²³	Patients aged 45-69 y	Mild hypertension	DBP 90-99	Goal: doses doubled (or chlorthalidone/enalapril added) for DBP <95 mm Hg (over 3 successive visits) or <105 mm Hg (single visit) Agents: nutritional-hygienic intervention plus 1 of 5 groups^e: acebutolol (400-800 mg/d), amlodipine (5-10 mg/d), chlorthalidone (15-30 mg/d), doxazosin (2-4 mg/d), or enalapril (5-10 mg/d)	Nutritional-hygienic intervention plus placebo Agents: provide chlorthalidone if BP not controlled with nutritional-hygienic intervention	Seated: mean of 2 measures Standing: 1 measure 2 min after standing	CVD or all-cause mortality: 4.4 All-cause mortality: 4.4	Primary end point (major coronary heart disease events, including myocardial infarction and heart failure), nonfatal stroke, or death due to any cause

Abbreviations: BP, blood pressure; CVD, cardiovascular disease; DBP, diastolic blood pressure; MAP, mean arterial pressure; SBP, systolic blood pressure.

^{^a}

Range varied based on baseline antihypertensive medication use: SBP 130-160 mm Hg with 0-3 antihypertensives, SBP 161-170 with 0-2 antihypertensives, or SBP 171-180 with 0-1 antihypertensives.

^{^b}

Of 4 measures, the first was discarded and the mean of the next 3 consecutive readings with a coefficient of variation below 15% was used in the study.

^{^c}

The average seated DBP was later changed to <110 mm Hg to be able to recruit participants with isolated systolic hypertension.

^{^d}

Range was 130-219 mm Hg and DBP <85 mm Hg if taking antihypertensive medications.

^{^e}

These groups were combined to represent the “intensive blood pressure treatment group” in our extended pooled meta-analysis, which included the 4 placebo-controlled studies.