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."