How Low Do We Go (in the Post-SPRINT Era)?

Adv Chronic Kidney Dis. 2019 Mar;26(2):110-116. doi: 10.1053/j.ackd.2019.01.007.

Abstract

Hypertension is frequently both a cause and complication of CKD. The optimal blood pressure target in CKD has been of hot debate over the decades with little data to inform the goals. Here, we review the data from the Systolic Blood Pressure Intervention Trial (SPRINT), Modification of Diet in Renal Disease (MDRD), African American Study of Kidney Disease and Hypertension (AASK), Ramipril Efficacy in Nephropathy-2 (REIN-2), and Action to Control Cardiovascular Risk in Diabetes (ACCORD) trials to use the available evidence to better inform what blood pressure goal should be recommended in patients with CKD and to answer the question "How low should we go?".

Keywords: Cardiovascular disease; Chronic kidney disease; Hypertension; SPRINT; Systolic blood pressure.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Acute Kidney Injury / epidemiology
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure
  • Diabetic Nephropathies / complications*
  • Evidence-Based Medicine
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Patient Care Planning*
  • Proteinuria / complications
  • Renal Insufficiency, Chronic / complications*

Substances

  • Antihypertensive Agents