Key result
Targeting a systolic blood pressure around 130 mm Hg optimizes both renal and cardiovascular protection, though too low levels may paradoxically increase renal morbidity via a J-curve relationship.
Why the study?
Does intensive blood pressure lowering below a certain threshold increase renal morbidity in patients with hypertension and kidney disease?
Does intensive blood pressure lowering below a certain threshold increase renal morbidity in patients with hypertension and kidney disease?
A systolic blood pressure target of around 130 mm Hg optimizes both renal and cardiovascular protection, highlighting the potential harm of excessively lowering blood pressure in renal patients.
Answers are grounded in this paper and cite their sources.
Supports SBP target near 130 mm Hg to balance renal-CV protection; leaves open prospective RCT confirmation of J-curve risk in CKD.
A bidirectional relationship between hypertension and kidney disease, with one exacerbating the effect of the other, is well established. Elevated blood pressure (BP) is a well-recognized, modifiable risk factor for cardiovascular (CV) disease as well as for development and progression of chronic kidney disease and, therefore, the identification of optimal BP target is a key issue in the management of renal patients. Recent large trials and real life cohort studies have indicated that below a definite BP value renal protection seems to plateau and too low levels may even be associated with a paradoxical increase in renal morbidity, thus reviving the debate about the so called BP -renal function J-curve relationship. Existing evidence supports a systolic target around 130 mm Hg to combine both renal and CV protection and possibly lower levels in the presence of overt proteinuria.
No takes yet. Share an insight, caveat, or question.
Viazzi et al. (2018) conducted a review in Hypertension and chronic kidney disease. Antihypertensive treatment was evaluated. Targeting a systolic blood pressure around 130 mm Hg optimizes both renal and cardiovascular protection, though too low levels may paradoxically increase renal morbidity via a J-curve relationship.
Synapse has enriched 10 related papers. Consider them for comparative context: