Key result
SBP 140-169 is not linked to higher mortality in older CKD, whereas SBP <120 is.
Why the study?
Hypertension is associated with poor outcomes in CKD at ages under 70 years, but this association is unclear at older ages.
Does systolic blood pressure level affect mortality and cardiovascular outcomes in older adults with CKD stages 3 and 4?
Population
158,713 subjects with CKD3 and 6,611 with CKD4 without diabetes or proteinuria
Comparison
Clinical SBP categories
Design
Retrospective cohort study
Follow-up
Mean 5.7 years
Authors
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Caution against SBP <120 mmHg in older CKD 3-4 adults; leaves optimal targets open for RCTs.
Cohort (n=165,324)
Does systolic blood pressure level affect mortality and cardiovascular outcomes in older adults with CKD stages 3 and 4?
In older adults with CKD stages 3-4, moderate systolic hypertension (140-169 mmHg) does not increase mortality, whereas intensive lowering (<120 mmHg) is associated with higher mortality and cardiovascular risk.
Masoli et al. (2019) conducted a cohort in Chronic kidney disease Stages 3 and 4 (n=165,324). Systolic blood pressure vs. SBP 130-139 mmHg was evaluated on 10-year mortality and cardiovascular outcomes. In older adults with CKD stages 3 and 4, SBP 140-169 mmHg was not associated with increased mortality compared to 130-139 mmHg, while SBP <120 mmHg was associated with increased mortality.
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