Why the study?
A more important early decline in GFR linked to antihypertensive therapy and strict blood pressure targets remains of concern, and few data exist from trials and observational studies.
Does a major early decline in GFR after starting antihypertensive therapy predict end-stage kidney disease and cardiovascular outcomes?
Does a major early decline in GFR after starting antihypertensive therapy predict end-stage kidney disease and cardiovascular outcomes?
Major early reductions in GFR after initiating ACEi/ARB or intensive BP control are predictive of end-stage kidney disease.
Reassures on safety of intensive BP lowering despite early GFR drops; strengthens support for strict targets in hypertension.
Blood pressure control, which can induce a slight decrease in the glomerular filtration rate (GFR), plays a nephron- and cardioprotective role. However, the more important early decline in GFR associated with antihypertensive therapy and strict blood pressure targets is still of concern. Since few data are available from trials and observational studies, and the phenomenon is relatively rare, we performed a meta-analysis of available studies. We conclude that major reductions in the glomerular filtration rate occurring soon after starting angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and/or under intensive blood pressure control predict end-stage kidney disease.
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Gambaro et al. (2021) studied this question.
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