Blood Pressure and Mortality in Older Patients with Kidney Disease

Although guidelines recommend a target blood pressure of <130/80 mm Hg for patients with chronic kidney disease (Am J Kidney Dis 2003; 42 (Suppl 3):S1), robust evidence supporting this recommendation is lacking. In this retrospective cohort study, researchers identified 8000 older community-dwelling people (age, ≥75) with estimated glomerular filtration rates (eGFRs) <60 mL/min/1.73 m²; 5-year outcomes were calculated as a function of baseline blood pressure (BP). Most patients were taking at least one BP-lowering medication.

In comorbidity-adjusted analyses, baseline BP predicted 5-year mortality in a J-shaped fashion: Mortality was significantly higher among people with systolic BP <130 mm Hg than among those with systolic BP of 131 to 160…