Lowering blood pressure may reduce risk of kidney disease progression

January 16, 2016

In the current study, patients ranged in age from 18 to 70, with an average age of 55. Nearly 40 percent of the patients were female. The patients came from 21 centers throughout the United States; 77 patients were treated at UT Southwestern.

To test if a lower blood pressure goal would help African-Americans with chronic kidney disease, AASK researchers broke the study into two phases. From 1995 to 1998, patients were randomly assigned 1,094 to receive either intensive blood pressure treatment to reach levels below 130/80 mm Hg, or standard blood pressure control of 140/90 mm Hg. They were monitored for three and six years.

After completion of the trial, a second phase known as the AASK cohort study included patients who were then switched to the same medication, and all eventually had a blood pressure target of 130/80 mm Hg. Blood pressure levels and hypertension were monitored every two years for patients whose disease had not progressed. Some patients were followed for up to 12 years.

Based on evidence emerging from other studies, AASK researchers also analyzed their data based on how much protein was found in each patient's urine. About one-third of patients had protein in the urine.

Among those patients, the risk of disease progression was reduced by 27 percent - a significant difference, Dr. Toto said.

"UT Southwestern was involved in the pilot study back in 1992, as well as in the 12 years of follow-up through the end of the cohort study," Dr. Toto said. "We're at the forefront of ensuring that clinical practice follows evidence."

Source: The New England Journal of Medicine