How do the results of the ESPRIT trial, which evaluated the impact of an SBP target of <120 mmHg on preventing major cardiovascular events, influence your blood pressure management goals for hypertensive patients with diabetes or a history of stroke?

The ESPRIT trial largely validates findings from SPRINT in a Chinese population. One major difference is that 38% of ESPRIT participants had diabetes mellitus (DM). A reduction in death from a CV cause drove the significance in the primary outcome (similar to SPRINT), and BP was measured 3x after a 5 min wait (similar to AOBP in SPRINT). Based on ESPRIT we can be more confident in targeting lower BPs in broader patient populations, including patients with DM and different ethnic backgrounds. The findings seem to support current BP goal/guidelines. We probably should start to use more automated office BP measurement (where multiple BP readings are averaged) in our clinics.