A RECENT study has demonstrated that intensive blood pressure (BP) control offers significant cardiovascular benefits for patients with chronic kidney disease (CKD), suggesting its effectiveness extends beyond clinical trials to real-world populations.
The study evaluated data from 99,921 CKD patients in two major healthcare systems: the Veterans Health Administration (VHA) and Kaiser Permanente of Southern California (KPSC). These patients met the eligibility criteria of the landmark Systolic Blood Pressure Intervention Trial (SPRINT), which had previously established the benefits of lower BP targets.
The analysis revealed that intensive BP control reduced the absolute risk of major cardiovascular events over four years by 5.1% in the VHA population and 3.0% in the KPSC population. However, the approach also carried higher risks of adverse events, increasing by 1.3% in the VHA group and 3.1% in the KPSC group.
While the cardiovascular benefits of intensive BP control were consistent with SPRINT findings, the trial’s effects on cognitive outcomes and CKD progression did not fully translate to these real-world populations, possibly due to differences in patient characteristics, such as older age and higher prevalence of albuminuria.
“These findings highlight the potential population-level benefits of implementing intensive BP targets in CKD management, particularly for reducing fatal and nonfatal cardiovascular events,” the researchers concluded.
The study underscores the importance of tailoring BP management strategies to balance cardiovascular benefits against the risk of adverse events, especially in older and more complex CKD populations.
Aleksandra Zurowska, EMJ
Reference
Kurella TM et al. SPRINT Treatment Among Adults With Chronic Kidney Disease From 2 Large Health Care Systems. JAMA Netw Open. 2025;8(1):e2453458.
