{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:45:34Z","timestamp":1784940334525,"version":"3.55.0"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,8,20]]},"abstract":"\n Background<\/jats:title>\n \n Our objective was to explore the effect of intensive blood pressure (\n BP<\/jats:styled-content>\n ) control on kidney and death outcomes among subgroups of patients with chronic kidney disease divided by baseline proteinuria, glomerular filtration rate, age, and body mass index.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We included 840 MDRD (Modification of Diet in Renal Disease) trial and 1067 AASK (African American Study of Kidney Disease and Hypertension) participants. We used Cox models to examine whether the association between intensive\n BP<\/jats:styled-content>\n control and risk of end\u2010stage renal disease (\n ESRD<\/jats:styled-content>\n ) or death is modified by baseline proteinuria (\u22650.44 versus <0.44\u00a0g\/g), glomerular filtration rate (\u226530 versus <30\u00a0mL\/min per 1.73\u00a0m\n 2<\/jats:sup>\n ), age (\u226540 versus <40\u00a0years), or body mass index (\u226530 versus <30\u00a0kg\/m\n 2<\/jats:sup>\n ). The median follow\u2010up was 14.9\u00a0years. Strict (versus usual)\n BP<\/jats:styled-content>\n control was protective against\n ESRD<\/jats:styled-content>\n (hazard ratio [HR]\n ESRD<\/jats:sub>\n , 0.77; 95%\n CI<\/jats:styled-content>\n , 0.64\u20130.92) among those with proteinuria \u22650.44\u00a0g\/g but not proteinuria <0.44\u00a0g\/g. Strict (versus usual)\n BP<\/jats:styled-content>\n control was protective against death (\n HR<\/jats:styled-content>\n death<\/jats:sub>\n , 0.73; 95%\n CI<\/jats:styled-content>\n , 0.59\u20130.92) among those with glomerular filtration rate <30\u00a0mL\/min per 1.73\u00a0m\n 2<\/jats:sup>\n but not glomerular filtration rate \u226530\u00a0mL\/min per 1.73\u00a0m\n 2<\/jats:sup>\n (\n HR<\/jats:styled-content>\n death<\/jats:sub>\n , 0.98; 95%\n CI<\/jats:styled-content>\n , 0.84\u20131.15). Strict (versus usual)\n BP<\/jats:styled-content>\n control was protective against\n ESRD<\/jats:styled-content>\n among those \u226540\u00a0years (\n \n HR\n ESRD<\/jats:sub>\n <\/jats:styled-content>\n ,<\/jats:sub>\n 0.82; 95%\n CI<\/jats:styled-content>\n , 0.71\u20130.94) but not <40\u00a0years. Strict (versus usual)\n BP<\/jats:styled-content>\n control was also protective against\n ESRD<\/jats:styled-content>\n among those with body mass index \u226530\u00a0kg\/m\n 2<\/jats:sup>\n (\n \n HR\n ESRD<\/jats:sub>\n <\/jats:styled-content>\n ,<\/jats:sub>\n 0.75; 95%\n CI<\/jats:styled-content>\n , 0.61\u20130.92) but not body mass index <30\u00a0kg\/m\n 2<\/jats:sup>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The\n ESRD<\/jats:styled-content>\n and all\u2010cause mortality benefits of intensive\n BP<\/jats:styled-content>\n lowering may not be uniform across all subgroups of patients with chronic kidney disease. But intensive\n BP<\/jats:styled-content>\n lowering was not associated with increased risk of\n ESRD<\/jats:styled-content>\n or death among any subgroups that we examined.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.012749","type":"journal-article","created":{"date-parts":[[2019,8,14]],"date-time":"2019-08-14T09:06:07Z","timestamp":1565773567000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":46,"title":["Effect of Blood Pressure Control on Long\u2010Term Risk of End\u2010Stage Renal Disease and Death Among Subgroups of Patients With Chronic\u00a0Kidney Disease"],"prefix":"10.1161","volume":"8","author":[{"given":"Elaine","family":"Ku","sequence":"first","affiliation":[{"name":"Division of Nephrology Department of Medicine University of California San Francisco San Francisco, CA"},{"name":"Division of Pediatric Nephrology Department of Pediatrics University of California San Francisco San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Sarnak","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Medicine Tufts University Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Toto","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center Dallas TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles E.","family":"McCulloch","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California, San Francisco San Francisco CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California, San Francisco San Francisco CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miroslaw","family":"Smogorzewski","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Department of Medicine University of Southern California Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi\u2010yuan","family":"Hsu","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Medicine University of California San Francisco San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","first-page":"e33","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APHA\/ASH\/ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology\/American Heart Association task force on clinical practice guidelines","volume":"72","author":"Whelton PK","year":"2017","unstructured":"Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr, Williamson JD, Wright JT Jr. 2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APHA\/ASH\/ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology\/American Heart Association task force on clinical practice guidelines. 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