Context

Hypertension is a major cause of mortality. Previous studies have identified a J-shaped association between systolic blood pressure (SBP) and risk of mortality, raising concerns about the safe limits of blood pressure lowering in certain patient populations. Patients with chronic kidney disease (CKD) represent 13% of the US population and have high prevalence of cardiovascular morbidity and a high mortality rate. However, data on optimal blood pressure targets in this high-risk patient population is limited. The few published trials of blood pressure in patients with CKD have primarily focused on kidney end points.1 ,2 Prior observational studies of patients with CKD have suggested that …