Key result
Achieved systolic blood pressure >149 mmHg increased the risk of doubling serum creatinine or ESRD by 2.2-fold compared with <134 mmHg, while irbesartan provided independent renoprotection.
Why the study?
Does achieved systolic blood pressure control and irbesartan improve renal outcomes and survival in hypertensive patients with type 2 diabetic nephropathy?
Population
1590 hypertensive patients with type 2 diabetes and diabetic nephropathy, multinational.
Comparison
Irbesartan or amlodipine, with other… vs Placebo, with other antihypertensive agents…
Design
RCT, randomized, double-blind, placebo-controlled
Follow-up
median 2.6 years
Authors
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Supports targeting SBP <134 mmHg with irbesartan in type 2 diabetic nephropathy; extends evidence for intensive BP control plus RAS blockade.
RCT (n=1,590)
double-blind
randomized
Yes
Does achieved systolic blood pressure control and irbesartan improve renal outcomes and survival in hypertensive patients with type 2 diabetic nephropathy?
Relative Risk: 2.2
Targeting a systolic blood pressure between 120 and 130 mmHg, combined with renin-angiotensin system blockade, optimizes renal outcomes and survival in patients with type 2 diabetic nephropathy.
Pohl et al. (2005) conducted an RCT in hypertensive patients with type 2 diabetes (n=1,590). Achieved SBP >149 mmHg vs. Achieved SBP <134 mmHg was evaluated on doubling serum creatinine or ESRD (RR 2.2). Achieved systolic blood pressure >149 mmHg increased the risk of doubling serum creatinine or ESRD by 2.2-fold compared with <134 mmHg, while irbesartan provided independent renoprotection.
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