Lower Blood Pressure in Patients with CKD Is Associated with Fewer Adverse Cardiovascular Events

Chronic kidney disease (CKD) is associated with hypertension and risk for cardiovascular (CV) disease. Whether drug therapy to lower blood pressure (BP) in patients with CKD lowers CV risk is unclear. In this meta-analysis of 25 randomized trials (152,000 participants, 30% with CKD), investigators determined the CV effects of BP-lowering drug therapy in people with CKD (glomerular filtration rate [GFR], <60 mL/minute/1.73m²) or without CKD.

Compared with placebo, angiotensin-converting–enzyme (ACE) inhibitors lowered risk for major adverse CV events by 19%, and calcium-channel blockers (CCBs) lowered risk by 28%, regardless of patients' baseline GFRs. Compared with placebo, ACE inhibitors or CCBs reduced adverse CV events by 17% for every re…