Wake Forest School of Medicine was a key contributor in the findings that demonstrated lowering blood pressure to below 130 mm HG in people, especially older people, can reduce the risk of heart attack, heart failure, stroke and death by 30-40%. Expanding on these findings in the SPRINT Mind study, our researchers published again in 2019, showing that such a reduction in blood pressure can reduce the risk of memory loss, early dementia or combined early or late dementia by 20%—the first intervention in history that clearly showed efficacy in reducing the risk for memory loss.
The IGLOO Project (Implementation of Guidelines for Lowering Blood Pressure), is focused on the blood pressure findings from the SPRINT study. IGLOO will speed up the traditional timeline and close the “gap” for implementing these new recommendations.
As part of CHI’s mission to accelerate translation of scientific and medical innovations from the academic world to clinical medicine, IGLOO was designed to more rapidly establish these new findings into the patient care environment.
IGLOO is currently rolling out the updated blood pressure measurement protocol in Wake Forest Baptist’s network clinics, a group of 125 clinics and 450 providers.
IGLOO is the embodiment of an important growing trend in medicine and health care called learning health systems—organizations or networks that continuously self-study and adapt using data and analytics to generate knowledge, engage stakeholders and implement behavior change to transform practice.
As the new method rolls out among the clinics, new data is being gathered that is helping adoption and implementation. The goal is to implement this new protocol in all of Wake Forest Baptist’s patient-facing clinics and services, not just the network clinics, and eventually across all of the Southeast through its partner organization, Atrium Health.
SPRINT TrialThe Systolic Blood Pressure Intervention Trial, or SPRINT , was a federally-funded trial that started in 2010 and involved almost 10,000 people age 50 or older across the United States and Puerto Rico. The findings were clear that treating to the lower target of less than 130 mm Hg reduced cardiovascular events and helped save lives.
Wake Forest was a key player in SPRINT, serving as the National Coordinating Center. The study generated an entirely new set of guidelines for controlling blood pressure, formulated jointly by the American Heart Association and the American College of Cardiology.
As SPRINT was in progress, researchers discovered that standard blood pressure measurement is not as accurate as the automated blood pressure measurement used in the study. Closer examination revealed that the standard method of measuring blood pressure—manual measurement with little consideration of the timing of the test—was inaccurate compared to a newly developed method using averaged readings from an automated blood pressure cuff.
A more accurate measure will result in more accurate treatment, so that patients are not over- or undermedicated.