Intensive systolic blood pressure control and incident chronic kidney disease in people with and without diabetes mellitus: secondary analyses of two randomised controlled trials

Publication date: Available online 21 April 2018 Source:The Lancet Diabetes & Endocrinology Author(s): Srinivasan Beddhu, Tom Greene, Robert Boucher, William C Cushman, Guo Wei, Gregory Stoddard, Joachim H Ix, Michel Chonchol, Holly Kramer, Alfred K Cheung, Paul L Kimmel, Paul K Whelton, Glenn M Chertow Background Guidelines, including the 2017 American College of Cardiology and American Heart Association blood pressure guideline, recommend tighter control of systolic blood pressure in people with type 2 diabetes. However, it is unclear whether intensive lowering of systolic blood pressure increases the incidence of chronic kidney disease in this population. We aimed to compare the effects of intensive systolic blood pressure control on incident chronic kidney disease in people with and without type 2 diabetes. Methods The Systolic Blood Pressure Intervention Trial (SPRINT) tested the effects of a systolic blood pressure goal of less than 120 mm Hg (intensive intervention) versus a goal of less than 140 mm Hg (standard intervention) in people without diabetes. The Action to Control Cardiovascular Risk in Diabetes (ACCORD) blood pressure trial tested a similar systolic blood pressure intervention in people with type 2 diabetes. Our study is a secondary analysis of limited access datasets from SPRINT and the ACCORD trial obtained from the National Institutes of Health. In participants without chronic kidney disease at baseline (n=4311 in the ACCORD trial...
Source: The Lancet Diabetes and Endocrinology - Category: Endocrinology Source Type: research