Achieving ideal systolic blood pressure (SBP) at the expense of lower–than–ideal diastolic blood pressure (DBP) could be harmful in adults with chronic kidney disease (CKD).

In a review of US veterans with CKD, SBP of 130 to 159 mm Hg and DBP of 70 to 89 mm Hg were associated with the lowest mortality rates as per a study that appeared Aug 20 in the Annals of Internal Medicine. Those in whom both SBP and DBP were concomitantly very high or very low had the highest mortality rates.

Patients with moderately elevated SBP combined with DBP no less than 70 mm Hg had consistently lower mortality rates than did patients with ideal SBP combined with DBP less than 70 mm Hg. Results were consistent in subgroups of patients with normal and elevated urinary microalbumin-creatinine ratios. Nearly one–third (32.5%) of the patients in the study cohort had SBP greater than 140 mm Hg and DBP less than 70 mmHg.

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