Beddhu S, et al. - This trial interrogated the effects of intensive systolic blood pressure (SBP) lowering on kidney and cardiovascular outcomes. This study also compared its apparent beneficial and adverse effects. A greater risk for incident chronic kidney disease (CKD) events was noted as a result of intensive SBP lowering. This was, nevertheless, outweighed by cardiovascular and all-cause mortality benefits.

Methods

• The scheme of this research was a subgroup analyses of SPRINT (Systolic Blood Pressure Intervention Trial).
• The enrollees consisted of adults with high blood pressure and elevated cardiovascular risk.
• 6662 individuals were recruited, with a baseline estimated glomerular filtration rate (eGFR) of at least 60 mL/min/1.73 m².
• The intervention comprised of random assignment to an intensive or standard SBP goal (120 or 140 mm Hg, respectively).
• The measurements included variations in mean eGFR during follow-up (estimated with a linear mixed-effects model), prespecified incident CKD (defined as a >30% decrease in eGFR to a value <60 mL/min/1.73 m²), and a composite of all-cause death or cardiovascular event, with surveillance every 3 months.

Results

• The data reported variation in adjusted mean eGFR between the intensive and standard groups as follows: -3.32 mL/min/1.73 m² (95% CI, -3.90 to -2.74 mL/min/1.73 m²) at 6 months, was -4.50 mL/min/1.73 m² (CI, -5.16 to -3.85 mL/min/1.73 m²) at 18 months.
• It was considerably stable thereafter.
• There was an occurrence of incident CKD event in 3.7% of the enrollees in the intensive group and 1.0% in the standard group at 3-year follow-up, with a hazard ratio of 3.54 (CI, 2.50 to 5.02).
• 4.9% and 7.1% were the corresponding percentages for the composite of death or cardiovascular event, at 3-year follow-up, with a hazard ratio of 0.71 (CI, 0.59 to 0.86).