Li Y, et al. - This study was performed on hypertensive patients with mild to moderate chronic kidney disease to determine the impact of achieved blood pressure (BP) on first stroke and renal function decline. Findings demonstrated that a BP treatment level of ≤135/80 mmHg versus a BP treatment level of 135–140/80–90 mmHg had the potential to attenuate the risk of first stroke in this patient population.

Methods

• This study included overall 3230 hypertensive patients with estimated glomerular filtration rate 30–60 mL/min/1.73 m² and/or proteinuria.
• Eligible participants were randomly assigned to a daily treatment of a combined enalapril 10 mg and folic acid 0.8 mg tablet or an enalapril 10 mg tablet alone.
• A follow-up was also performed every 3 months.
• First stroke and the progression of CKD were the study outcomes.

Results

• 4.7 years was the median antihypertensive treatment duration.
• Findings demonstrated that the incidence of total first stroke [1.7% versus 3.3%; hazard ratio (HR), 0.51; 95% confidence interval (CI): 0.26–0.99] and ischemic stroke (1.3% versus 2.8%; HR, 0.46; 95% CI: 0.22–0.98) decreased significantly in those with a time-averaged SBP of ≤135 mmHg, compared with those with a time-averaged on-treatment systolic blood pressure (SBP) of 135 to ≤140 mmHg.
• Furthermore, researchers observed that a time-averaged diastolic blood pressure (DBP) of ≤80 mmHg, compared with a time-averaged DBP level of 80 to ≤90 mmHg, was significantly related to a decreased risk of hemorrhagic stroke (0.2% versus 0.9%; HR, 0.18; 95% CI: 0.04–0.80).
• However, data also reported that compared with participants with a time-averaged SBP of 135 to ≤140 mmHg, a lower but non-significant trend of CKD progression was found in those with a time-averaged SBP of ≤130 mmHg.