Managing Hypertension in Patients with CKD: A Marathon, Not a SPRINT

Area of Science:

• Nephrology
• Cardiovascular Medicine
• Clinical Trials

Background:

• Hypertension management is crucial for patients with mild to moderate chronic kidney disease (CKD).
• The Systolic Blood Pressure Intervention Trial (SPRINT) investigated the effects of intensive versus standard blood pressure targets.
• Understanding optimal anti-hypertensive therapy intensity is essential for improving CKD outcomes.

Purpose of the Study:

• To provide context and background for the SPRINT trial's primary analysis results.
• To review existing evidence on the safety and efficacy of different anti-hypertensive therapy intensities in CKD.
• To identify remaining evidence gaps and encourage renewed focus on hypertension in nephrology.

Main Methods:

• Review of published evidence regarding anti-hypertensive therapy in mild to moderate CKD.
• Analysis and discussion of the primary results from the Systolic Blood Pressure Intervention Trial (SPRINT).
• Expert interpretation by nephrologist-investigators from a SPRINT Clinical Center Network.

Main Results:

• SPRINT primary analysis results provide critical data on intensive blood pressure management.
• Evidence highlights the safety and efficacy of varying anti-hypertensive strategies in CKD patients.
• The trial data will inform clinical practice guidelines for hypertension in CKD.

Conclusions:

• SPRINT findings offer significant guidance for managing hypertension in individuals with mild to moderate CKD.
• The study underscores the importance of evidence-based anti-hypertensive therapy intensity.
• A call to action for the nephrology community to prioritize hypertension clinical care and research.