
Does a blood pressure J curve exist for patients with chronic kidney disease?
Author(s) -
Robles Nicolás Roberto,
HernandezGallego Roman,
Fici Francesco,
Grassi Guido
Publication year - 2017
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.13024
Subject(s) - medicine , blood pressure , kidney disease , confounding , renal function , cardiology , disease , intensive care medicine
Aggressive reduction of blood pressure may increase cardiovascular events (the J‐curve phenomenon) in certain populations. In this regard, most studies in patients with chronic kidney disease have shown a J curve for cardiovascular morbidity and mortality, and this phenomenon persists after adjusting for confounding factors. Since there is no evidence that a straighter blood pressure target (<130/70 mm Hg) could improve renal outcomes, the increased cardiovascular risk associated with extreme blood pressure reduction should be seen as undesirable. Moreover, the intensive control of blood pressure may induce an unintended reduction of renal function and this decrease, in turn, may increase cardiovascular risk.