Why the study?
To examine the association of CKD with recurrent stroke and assess whether baseline renal function modifies the effects of intensive systolic blood pressure control in patients with previous stroke.
Does an intensive systolic blood pressure target of <130 mm Hg reduce recurrent stroke and cardiovascular events in patients with previous lacunar stroke and CKD?
Population
3017 patients with recent MRI-defined symptomatic lacunar infarctions and baseline eGFR measurements
Comparison
Systolic blood pressure target <130 mm Hg vs 130 to 149 mm Hg across kidney function
Design
Post hoc analysis of a randomized controlled trial
Authors
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CKD marks higher recurrent risk after lacunar stroke; leaves open whether intensive SBP targets warrant dedicated testing in this subgroup.
Does an intensive systolic blood pressure target of <130 mm Hg reduce recurrent stroke and cardiovascular events in patients with previous lacunar stroke and CKD?
In patients with previous lacunar stroke, baseline CKD increases the risk of recurrent stroke by 50%, but does not modify the treatment effect of intensive systolic blood pressure control.
Agarwal et al. (2019) studied this question.
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