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Blood Pressure Targets in CKD: Lessons Learned from SPRINT and Previous Observational Studies

  • Hypertension (AJ Peixoto and DS Geller, Section Editors)
  • Published:
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Abstract

Hypertension management is one of the most common clinical tasks in the care of patients with chronic kidney disease (CKD). Elevated blood pressure (BP) is associated with greater risk of all-cause mortality, cardiovascular (CV) disease, and CKD progression in this population. However, it is still debated, to what target(s) BP should be lowered in patients with signs of kidney damage. The Systolic Blood Pressure Intervention Trial (SPRINT) provided new and important information about the effects of lowering systolic BP to a target of <120 mmHg, which is lower than the levels currently recommended by the most guidelines (<140/90 mmHg). The SPRINT results were not only exciting but also surprising for many clinicians because evidence from well-conducted observational studies in CKD patient showed increased mortality in patients with CKD whose office systolic BP levels were <120 mmHg, as compared with systolic BP in 120–139 mmHg range. In the present review, we will discuss whether a systolic BP goal of <120 mmHg that was found to be beneficial for CV and all-cause mortality outcomes in the SPRINT can be generalized to the entire CKD population.

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Acknowledgments

EOG and CPK are employees of the US Department of Veterans Affairs. Opinions expressed in this paper are those of the authors’ and do not necessarily represent the opinion of the Department of Veterans Affairs.

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Authors and Affiliations

  1. Nephrology Division, Department of Medicine, Albany Medical College, Albany, NY, USA

    Elvira O. Gosmanova

  2. Nephrology Section, Stratton VA Medical Center, Albany, NY, USA

    Elvira O. Gosmanova

  3. Nephrology Division, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA

    Csaba P. Kovesdy

  4. Nephrology Section, Memphis VA Medical Center, 1030 Jefferson Ave., Memphis, TN, 38104, USA

    Csaba P. Kovesdy

Authors
  1. Elvira O. Gosmanova
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  2. Csaba P. Kovesdy
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Correspondence to Csaba P. Kovesdy.

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Elvira O. Gosmanova and Csaba P. Kovesdy declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Hypertension

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Gosmanova, E.O., Kovesdy, C.P. Blood Pressure Targets in CKD: Lessons Learned from SPRINT and Previous Observational Studies. Curr Cardiol Rep 18, 88 (2016). https://doi.org/10.1007/s11886-016-0769-y

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  • DOI: https://doi.org/10.1007/s11886-016-0769-y

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