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VNA of Care New England

Ideal BP for Kidney Disease Patients May Be 130-159/70-89

Blood pressure in this range associated with the lowest mortality rates
WEDNESDAY, Aug. 21 (HealthDay News) -- In patients with chronic kidney disease (CKD), optimal blood pressure (BP) seems to be 130 to 159/70 to 89 mm Hg, according to a study published in the Aug. 20 issue of the Annals of Internal Medicine.
Csaba P. Kovesdy, M.D., from the University of Tennessee Health Science Center in Memphis, and colleagues analyzed data from 651,749 U.S. veterans with CKD. BP data were examined in 96 categories from lowest (<80/<40 mm Hg) to highest (>210/>120 mm Hg), in 10 mm Hg increments.
The researchers found that the lowest adjusted mortality rates were seen in patients with BP of 130 to 159/70 to 89 mm Hg, while those in whom both systolic BP (SBP) and diastolic BP (DBP) were concomitantly very high or very low had the highest mortality rates. There were consistently lower mortality rates in patients with moderately elevated SBP combined with DBP no less than 70 mm Hg than in patients with ideal SBP combined with DBP less than 70 mm Hg. Results were consistent in subgroups of patients with normal and elevated urinary microalbumin-creatinine ratios.
"It may not be advantageous to achieve ideal SBP at the expense of lower-than-ideal DBP in adults with CKD," the authors write.
Full Text (subscription or payment may be required) (http://annals.org/article.aspx?articleid=1726794 )Editorial (subscription or payment may be required) (http://annals.org/article.aspx?articleid=1726833 )
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