February 15, 2007Journal of the American Society of Nephrology
Lowest Systolic Blood Pressure Is Associated with Stroke in Stages 3 to 4 Chronic Kidney Disease
Key result
In individuals with chronic kidney disease, systolic blood pressure <120 mmHg was associated with an increased risk of incident stroke compared to 120-129 mmHg (HR 2.51; 95% CI 1.30-4.87).
Why the study?
Does a lower systolic blood pressure (<120 mmHg) increase the risk of incident stroke in individuals with stages 3 to 4 chronic kidney disease?
Population
20,358 individuals from two community-based, longitudinal data sets, including 1,549 with chronic kidney…
Comparison
Systolic blood pressure (SBP) <120 mmHg vs Systolic blood pressure 120 to 129 mmHg, and…
Design
Cohort
Follow-up
median 111 months
Authors
Discussion
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Member takes
Implication
Low SBP may raise stroke risk in early CKD; leaves open optimal targets pending trials.
Study Design
Type
Cohort (n=20,358)
Multicenter
Yes
Structured PICO
Does a lower systolic blood pressure (<120 mmHg) increase the risk of incident stroke in individuals with stages 3 to 4 chronic kidney disease?
P
Population
20,358 individuals, including 1,549 with chronic kidney disease, from two community-based longitudinal cohorts followed for a median of 111 months.
E
Exposure
Systolic blood pressure (SBP) <120 mmHg
C
Comparator
Systolic blood pressure (SBP) 120 to 129 mmHg, and individuals without CKD
O
Outcome
Definite or probable incident strokehard clinical
Main Result
Hazard Ratio: 2.51 (95% CI 1.3–4.87)
In patients with stages 3 to 4 chronic kidney disease, there is a J-shaped relationship between systolic blood pressure and stroke risk, with SBP <120 mmHg significantly increasing the risk of incident stroke.
Cite This Study
Weiner et al. (2007) conducted a cohort in Chronic kidney disease (n=20,358). Systolic blood pressure <120 mmHg vs. Systolic blood pressure 120 to 129 mmHg was evaluated on definite or probable incident stroke (HR 2.51, 95% CI 1.30 to 4.87). In individuals with chronic kidney disease, systolic blood pressure <120 mmHg was associated with an increased risk of incident stroke compared to 120-129 mmHg (HR 2.51; 95% CI 1.30-4.87).