Intensive BP Control Provides Little Benefit in Chronic Kidney Disease
The researchers found that the cardiovascular benefit from intensive treatment was diminished with lower eGFR.
HealthDay News — Intensive blood pressure (BP) control may provide no benefit and may even be harmful for patients with moderate-to-advanced chronic kidney disease, according to a study published online in the Journal of Internal Medicine.
Yoshitsugu Obi, PhD, from the University of California Irvine Medical Center, and colleagues conducted post-hoc analysis of the Systolic Blood Pressure Intervention Trial to determine the risk-benefit profile of intensive BP control across estimated glomerular filtration rate (eGFR) levels.
The researchers found that the cardiovascular benefit from intensive treatment was diminished with lower eGFR (P interaction =.019), while eGFR did not alter the adverse effect on acute kidney injury (AKI; P interaction =.179).
For the 891 participants with eGFR <45 mL/min/1.73 m2, intensive treatment did not reduce the cardiovascular outcome (hazard ratio [HR], 0.92; 95% CI, 0.62-1.38), while it increased AKI (HR, 1.73; 95% CI, 1.12-2.66).
"Intensive BP control may provide little or no benefit and even be harmful for patients with moderate-to-advanced chronic kidney disease," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
Obi Y, Kalantar-Zadeh K, Shintani A, Kovesdy CP, Hamano T. Estimated glomerular ﬁltration rate and the risk–beneﬁtproﬁle of intensive blood pressure control amongstnondiabetic patients: a post hoc analysis of a randomizedclinical trial [published online October 16, 2017]. J Intern Med. doi:10.1111/joim.12701