BLOOD PRESSURE TARGET LEVELS EASED
If you have high blood pressure and you’re worried about the effect it is having on your kidneys, you may want to read this report. The logic on this subject for years has been that lowering blood pressure to below 130/80, or to as low as possible, as long as the patient can tolerate it, helps to prevent cardiovascular events and progression to end-stage renal disease. However, a recent Cochrane review reported in American Family Physician refutes that statement.
Cochrane is a global, independent, network of medical researchers that verifies the accuracy and validity of the research of other investigators. Cochrane is widely trusted and respected and is quoted regularly in research studies reported in Am Fam Phys.
Cochrane analyzed the blood pressures of 7348 patients in six controlled trials. These patients all had mild, early onset chronic kidney disease based on the presence of albumin (protein) in their urine and decreased kidney function tests. Decreased kidney function was determined by a lower than normal GFR, the rate at which kidneys filter the blood. Patients were placed in groups based on their BP. One group was the standard BP group whose BP’s were above 140/85. The lower BP group was the other. Their BP was targeted for lowering between 120/80 to 130/80.
What Cochrane learned was that the lower BP group had NO BETTER outcome in total mortality, total serious adverse events, or total cardiovascular events than the standard BP group. In other words, lowering one’s BP to barely tolerable levels had no beneficial effect on cardiovascular deaths, cardiovascular events, or progression to end-stage kidney disease.
These results have led several academic associations (American Heart Association, American College of Cardiology) to loosen the target levels physicians use to treat patients. Rather than treating to 120/80 or less, current guidelines recommend 140/90 or less as the current target.
Reference: Devaraj T, Clebak KT, Newberry ZS. Blood Pressure Targets for Hypertension in People with Chronic Kidney Disease Am Fam Phys 2025 June;111(6):495.
