Systolic Blood Pressure Intervention Trial

Exclusion Criteria

• •An indication for a specific BP lowering medication that the person is not taking and the person has not been documented to be intolerant of the medication class.
• •Known secondary cause of hypertension that causes concern regarding safety of the protocol.
• •One minute standing SBP \< 110 mm Hg.
• •Proteinuria in the following ranges (based on a measurement within the past 6 months)
• •* 24 hour urinary protein excretion ≥1 g/day, or
• •* 24 hour urinary albumin excretion ≥ 600 mg/day, or
• •* spot urine protein/creatinine ratio ≥ 1 g/g creatinine, or
• •* spot urine albumin/creatinine ratio ≥ 600 mg/g creatinine, or
• •* urine dipstick ≥ 2+ protein
• •Arm circumference too large or small to allow accurate blood pressure measurement with available devices
• •Diabetes mellitus,
• •History of stroke (not CE or stenting)
• •Diagnosis of polycystic kidney disease
• •Glomerulonephritis treated with or likely to be treated with immunosuppressive therapy
• •eGFR \< 20 ml/min /1.73m2 or end-stage renal disease (ESRD)
• •Cardiovascular event or procedure (as defined above as clinical CVD for study entry) or hospitalization for unstable angina within last 3 months
• •Symptomatic heart failure within the past 6 months or left ventricular ejection fraction (by any method) \< 35%
• •A medical condition likely to limit survival to less than 3 years or a malignancy other than non-melanoma skin cancer within the last 2 years
• •Any factors judged by the clinic team to be likely to limit adherence to interventions.
• •Failure to obtain informed consent from participant
• •Currently participating in another clinical trial (intervention study). Note: Patient must wait until the completion of his/her activities or the completion of the other trial before being screened for SPRINT.
• •Living in the same household as an already randomized SPRINT participant
• •Any organ transplant
• •Unintentional weight loss \> 10% in last 6 months
• •Pregnancy, currently trying to become pregnant, or of child-bearing potential and not using birth control.