Does a lower blood pressure goal or ACE inhibitor therapy reduce the progression of hypertensive nephrosclerosis compared to standard goals or other antihypertensive classes?
In patients with hypertensive kidney disease, ACE inhibitors are superior to beta-blockers or calcium channel blockers for slowing GFR decline, though a lower overall BP target does not provide additional benefit.
No additional benefit of slowing progression of hypertensive nephrosclerosis was observed with the lower BP goal. Angiotensin-converting enzyme inhibitors appear to be more effective than beta-blockers or dihydropyridine calcium channel blockers in slowing GFR decline.
Jackson T. Wright (2002) studied this question.