CLINICAL QUESTION

Is there a benefit to using a lower blood pressure (BP) target of 130/80 mm Hg for hypertension in people with chronic kidney disease (CKD) compared with a higher BP target of 140 to 160/90 to 100 mm Hg?

EVIDENCE-BASED ANSWER

Having a lower BP target of 130/80 mm Hg for hypertension in people with CKD compared with a higher BP target of 140 to 160/90 to 100 mm Hg does not reduce total mortality, total serious adverse events, total cardiovascular events, total cardiovascular mortality, or progression to end-stage renal disease.¹ (Strength of Recommendation: B, inconsistent or limited-quality patient-oriented evidence.)

PRACTICE POINTERS

The prevalence of CKD is estimated to be 14% in the United States.² Systemic hypertension is the second leading cause of CKD in the United States behind diabetes and is an independent risk factor for adverse cardiovascular events.^1,2 The authors of this Cochrane review aimed to identify the effects of lower vs higher BP targets on morbidity and mortality in people with CKD.¹