{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T22:31:46Z","timestamp":1764541906126},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n            <jats:title>Background and objectives<\/jats:title>\n            <jats:p>In the Systolic Blood Pressure Intervention Trial (SPRINT), intensive systolic BP treatment (target &lt;120 mm Hg) was associated with fewer cardiovascular events and higher incidence of kidney function decline compared with standard treatment (target &lt;140 mm Hg). We evaluated the association between mean arterial pressure reduction, kidney function decline, and cardiovascular events in patients without CKD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design, setting, participants, &amp; measurements<\/jats:title>\n            <jats:p>We categorized patients in the intensive treatment group of the SPRINT according to mean arterial pressure reduction throughout follow-up: &lt;20, 20 to &lt;40, and \u226540 mm Hg. We defined the primary outcome as kidney function decline (\u226530% reduction in eGFR to &lt;60 ml\/min per 1.73 m<jats:sup>2<\/jats:sup> on two consecutive determinations at 3-month intervals), and we defined the secondary outcome as cardiovascular events. In a propensity score analysis, patients in each mean arterial pressure reduction category from the intensive treatment group were matched with patients from the standard treatment group to calculate the number needed to treat regarding cardiovascular events and the number needed to harm regarding kidney function decline.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>In the intensive treatment group, 1138 (34%) patients attained mean arterial pressure reduction &lt;20 mm Hg, 1857 (56%) attained 20 to &lt;40 mm Hg, and 309 (9%) attained \u226540 mm Hg. Adjusted hazard ratios for kidney function decline were 2.10 (95% confidence interval, 1.22 to 3.59) for mean arterial pressure reduction between 20 and 40 mm Hg and 6.22 (95% confidence interval, 2.75 to 14.08) for mean arterial pressure reduction \u226540 mm Hg. In propensity score analysis, mean arterial pressure reduction &lt;20 mm Hg presented a number needed to treat of 44 and a number needed to harm of 65, reduction between 20 and &lt;40 mm Hg presented a number needed to treat of 42 and a number needed to harm of 35, and reduction \u226540 mm Hg presented a number needed to treat of 95 and a number needed to harm of 16.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>In the intensive treatment group of SPRINT, larger declines in mean arterial pressure were associated with higher incidence of kidney function decline. Intensive treatment seemed to be less favorable when a larger reduction in mean arterial pressure was needed to attain the BP target.<\/jats:p>\n          <\/jats:sec>","DOI":"10.2215\/cjn.05510517","type":"journal-article","created":{"date-parts":[[2017,11,4]],"date-time":"2017-11-04T00:40:29Z","timestamp":1509756029000},"page":"73-80","source":"Crossref","is-referenced-by-count":19,"title":["BP Reduction, Kidney Function Decline, and Cardiovascular Events in Patients without CKD"],"prefix":"10.2215","volume":"13","author":[{"given":"Rita","family":"Magri\u00e7o","sequence":"first","affiliation":[{"name":"Masters in Medicine, Nephrology Department, Hospital Garcia de Orta, Lisbon, Portugal;"}]},{"given":"Miguel","family":"Bigotte Vieira","sequence":"additional","affiliation":[{"name":"Masters in Medicine, Nephrology and Renal Transplantation Department, Centro Hospitalar Lisboa Norte, Lisbon, Portugal;"}]},{"given":"Catarina","family":"Viegas Dias","sequence":"additional","affiliation":[{"name":"Masters in Medicine, Dafundo Family Health Unit, Agrupamento de Centros de Sa\u00fade Lisboa Ocidental e Oeiras, Lisbon, Portugal;"}]},{"given":"Lia","family":"Leit\u00e3o","sequence":"additional","affiliation":[{"name":"Masters in Medicine, Neurology Department, Hospital Prof. Doutor Fernando da Fonseca, Amadora, Portugal;"}]},{"given":"Jo\u00e3o S\u00e9rgio","family":"Neves","sequence":"additional","affiliation":[{"name":"Masters in Medicine, Department of Endocrinology, Diabetes and Metabolism, S\u00e3o Jo\u00e3o Hospital Center, Porto, Portugal; and"},{"name":"Department of Surgery and Physiology, Cardiovascular Research Center, Faculty of Medicine, University of Porto, Porto, Portugal"}]}],"member":"276","published-online":{"date-parts":[[2017,11,3]]},"reference":[{"key":"B1-20230813","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/S0140-6736(05)17741-1","article-title":"Global burden of hypertension: Analysis of worldwide data.","volume":"365","author":"Kearney","year":"2005","journal-title":"Lancet"},{"key":"B2-20230813","doi-asserted-by":"crossref","first-page":"2103","DOI":"10.1056\/NEJMoa1511939","article-title":"A randomized trial of intensive versus standard blood-pressure control.","volume":"373","author":"Wright","year":"2015","journal-title":"N Engl J Med"},{"key":"B4-20230813","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1001\/jama.1993.03500040054036","article-title":"A prospective study of blood pressure and serum creatinine. 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