Lower Blood Pressure Goals for Cardiovascular and Renal Risk Reduction: Are They Defensible?
Key result
A systolic blood pressure goal of <140 mm Hg reduces cardiorenal risk, whereas evidence from prospective trials does not currently support a more aggressive goal of <130 mm Hg.
Why the study?
Does intensive blood pressure lowering to <130/80 mm Hg reduce cardiovascular and renal risk compared to <140/90 mm Hg in patients with diabetes or CKD?
Population
Patients with diabetes or chronic kidney disease (CKD)
Comparison
Intensive blood pressure lowering to a goal of… vs Standard blood pressure lowering to a goal of…
Design
Review
Authors
Discussion
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Member takes
Implication
Challenges <130/80 mm Hg targets in diabetes or CKD; leaves open whether prospective trials will support more intensive goals.
Structured PICO
Does intensive blood pressure lowering to <130/80 mm Hg reduce cardiovascular and renal risk compared to <140/90 mm Hg in patients with diabetes or CKD?
P
Population
Patients with diabetes or chronic kidney disease (CKD)
I
Intervention
Intensive blood pressure lowering to a goal of <130/80 mm Hg
C
Comparator
Standard blood pressure lowering to a goal of <140/90 mm Hg
O
Outcome
Cardiovascular disease risk reduction and chronic kidney disease (CKD) progressionhard clinical
This review challenges the guideline-recommended blood pressure goal of <130/80 mm Hg for patients with diabetes or CKD, arguing that prospective trial evidence only robustly supports a goal of <140 mm Hg.
Cite This Study
Kalaitzidis et al. (2009) conducted a review in Hypertension, Chronic Kidney Disease, Diabetes. Blood pressure goal <130/80 mm Hg vs. Blood pressure goal <140/90 mm Hg was evaluated on Cardiovascular disease risk reduction and CKD progression. A systolic blood pressure goal of <140 mm Hg reduces cardiorenal risk, whereas evidence from prospective trials does not currently support a more aggressive goal of <130 mm Hg.