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Risk of death found to be raised in chronic kidney disease patients with low diastolic blood pressure

BMJ 2013; 347 doi: (Published 20 August 2013) Cite this as: BMJ 2013;347:f5201
  1. Andrew Cole
  1. 1London

Rigorous control of hypertension is recommended for patients with chronic kidney disease, but a US study has found that patients with the condition have a higher risk of mortality if their diastolic blood pressure falls too low.1

Blood pressure recommendations are stricter for patients with chronic kidney disease than for the general population and focus on lowering systolic and diastolic blood pressure. Recent guidelines from the Kidney Disease Improving Global Outcomes Initiative recommended a blood pressure target of less than 140/90 mm Hg in chronic kidney patients who have no proteinuria and a stricter target of 130/80 mm Hg in patients with microalbuminuria and macroalbuminuria.2 The targets emphasize the importance of lowering systolic blood pressure but do not consider the potential clinical effects of low diastolic blood pressure.

However, …

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