CKD blood pressure therapy cuts cardiovascular risk across all stages, study finds

The analysis spans 46 trials, covering 285,124 patients.

Lowering blood pressure reduces major cardiovascular events in patients with chronic kidney disease (CKD) across all stages, including advanced disease, according to a meta-analysis published in The Lancet and highlighted by GlobalData.

The study by Zeng and colleagues analysed data from 46 randomised trials covering 285,124 participants.

It found that a five-mmHg reduction in systolic blood pressure lowered major cardiovascular events in CKD patients to a similar degree as in individuals without CKD.

The effect was consistent across CKD stages 1 to 5, including advanced stages 4 to 5 with a mean estimated glomerular filtration rate of about 25 millilitres per minute per 1.73 square metres.

Benefits were similar regardless of starting blood pressure or protein levels in urine, whilst different classes of blood pressure medicines produced comparable outcomes.

A reduced relative risk was observed in CKD patients with diabetes compared with those without diabetes.

The findings indicate that blood pressure-lowering therapy maintains cardiovascular benefit even in advanced CKD, a group that has been underrepresented in previous trials.

Kajal Jaddoo, Managing Pharma Analyst at GlobalData, said clinicians have often been cautious in later-stage CKD due to concerns about limited cardiovascular benefit or potential harm.

Jaddoo said the analysis supports a more proactive approach to cardiovascular risk reduction in this population.

The study suggests that blood pressure-lowering therapy remains effective across all CKD stages and may support broader use in high-risk patients.