Blood-pressure lowering reduces the risk for major cardiovascular events similarly well in people with and without chronic kidney disease, according to a BMJ meta-analysis.

 

Researchers examined 25 randomized trials comprising over 150,000 participants, about 20% of whom had a reduced estimated glomerular filtration rate (<60 mL/min). They found that BP-lowering regimens, compared with placebo, reduced the risk for major cardiovascular events by 17% for every 5-mm-Hg drop in systolic BP — both in patients with and without reduced eGFR. Findings generally did not differ according to drug class.

A higher absolute benefit was noted among patients with kidney disease: the number needed to treat to prevent one event was 35 among those with reduced eGFR, versus 53 among those with higher eGFR.

The researchers call BP-lowering “an effective strategy for preventing cardiovascular events among people with moderately reduced eGFR.” They add that “there is little evidence … to support the preferential choice of particular drug classes.”

 

 

BMJ article