Aggressive reduction of blood pressure (<130/70 mm Hg) in patients with chronic kidney disease is associated with a J-curve phenomenon for cardiovascular morbidity and mortality.
Does aggressive reduction of blood pressure increase cardiovascular events (J-curve phenomenon) in patients with chronic kidney disease?
Aggressive blood pressure reduction in patients with chronic kidney disease may increase cardiovascular risk and reduce renal function without providing additional renal benefits, supporting the existence of a J-curve phenomenon.
Aggressive reduction of blood pressure may increase cardiovascular events (the J-curve phenomenon) in certain populations. In this regard, most studies in patients with chronic kidney disease have shown a J curve for cardiovascular morbidity and mortality, and this phenomenon persists after adjusting for confounding factors. Since there is no evidence that a straighter blood pressure target (<130/70 mm Hg) could improve renal outcomes, the increased cardiovascular risk associated with extreme blood pressure reduction should be seen as undesirable. Moreover, the intensive control of blood pressure may induce an unintended reduction of renal function and this decrease, in turn, may increase cardiovascular risk.
Robles et al. (Wed,) conducted a review in Chronic kidney disease. Aggressive reduction of blood pressure was evaluated on Cardiovascular morbidity and mortality. Aggressive reduction of blood pressure (<130/70 mm Hg) in patients with chronic kidney disease is associated with a J-curve phenomenon for cardiovascular morbidity and mortality.
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