Key result
Intensive antihypertensive therapy targeting a systolic blood pressure of <120 mmHg yielded an approximately 30% relative reduction in the primary composite cardiovascular endpoint compared to standard therapy.
Why the study?
Does intensive anti-hypertensive therapy reduce cardiovascular events and mortality in patients with hypertension and mild to moderate CKD?
Does intensive anti-hypertensive therapy reduce cardiovascular events and mortality in patients with hypertension and mild to moderate CKD?
Effect estimate: approximately 30% relative reduction
Intensive blood pressure control (target <120 mmHg) reduces cardiovascular events and mortality in high-risk hypertensive patients, including those with mild to moderate CKD, though its applicability to advanced CKD remains uncertain.
In this manuscript, nephrologist-investigators from one of five Clinical Center Networks of the Systolic Blood Pressure Intervention Trial (SPRINT) provide background information and context on the intensity of anti-hypertensive therapy in conjunction with the release of detailed results from SPRINT's primary analysis. The authors highlight published evidence on the safety and efficacy of differing intensities of anti-hypertensive therapy in mild to moderate CKD, where SPRINT will help to inform practice, as well as where gaps in evidence will remain. The authors also challenge the nephrology community to renew its attention and efforts on hypertension clinical care and research.
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Chertow et al. (2015) conducted an editorial in Hypertension (n=9,361). Intensive antihypertensive therapy vs. Standard therapy (target systolic BP <140 mmHg) was evaluated on Composite of first occurrence of myocardial infarction, acute coronary syndrome, stroke, heart failure, or cardiovascular death (approximately 30% relative reduction). Intensive antihypertensive therapy targeting a systolic blood pressure of <120 mmHg yielded an approximately 30% relative reduction in the primary composite cardiovascular endpoint compared to standard therapy.
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