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July 18, 2026American Journal of Hypertension

High arterial stiffness is not significantly associated with kidney dysfunction during blood pressure lowering.

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Why the study?

Does intensive clinic blood pressure lowering increase kidney function decline in hypertensive patients with high arterial stiffness?

Population

266 patients with hypertension

Comparison

Intensive clinic blood pressure lowering with… vs Less intensive blood pressure lowering or lower…

Design

Cohort, double-blind

Follow-up

20 weeks

Key result

High arterial stiffness (tertile 3 vs 1) in hypertensive patients undergoing blood pressure lowering was associated with a higher incidence of kidney dysfunction (6.4% vs 0%; OR 2.23, 95% CI 0.84-5.95).

Authors

YWYue WangLYLi YJWJi-Guang Wang

Discussion

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Overview

High arterial stiffness may signal greater kidney risk during BP lowering; leaves open whether it modifies intensive therapy effects.

Key Points

  • This analysis aims to determine how blood pressure changes affect kidney function decline, particularly in patients with high arterial stiffness.
  • Post-hoc analysis of 266 hypertensive patients from a 20-week double-blind trial
  • Treatment involved calcium-channel blockers and blood pressure changes were measured
  • Kidney dysfunction was defined by eGFR and brachial-ankle pulse wave velocity (baPWV) was assessed.
  • After 20 weeks, kidney dysfunction incidence was 0%, 4.8%, and 6.4% in baPWV tertiles 1, 2, and 3 respectively
  • The odds ratio for kidney dysfunction in tertile 3 versus tertile 1 was 2.23 (95% CI, 0.84-5.95)
  • The average eGFR decline was -3.7 ml/min·1.73 m2 in patients with high baPWV and intensive BP reduction.

Study Design

Type

RCT (n=266)

Blinding

Double-blind

Randomization

randomized

Structured PICO

Does intensive clinic blood pressure lowering increase kidney function decline in hypertensive patients with high arterial stiffness?

P
Population
266 patients with hypertension treated with calcium-channel blockers, followed for 20 weeks to assess the impact of arterial stiffness on kidney function decline.
I
Intervention
Intensive clinic blood pressure lowering with calcium-channel blockers over 20 weeks
C
Comparator
Less intensive blood pressure lowering or lower baseline arterial stiffness
O
Outcome
Kidney dysfunction (defined as estimated glomerular filtration rate [eGFR] <60 ml/min·1.73 m2 or a decrease ≥30% from baseline)surrogate

Main Result

Odds Ratio: 2.23 (95% CI 0.84–5.95)

Absolute Event Rate: 6.4% vs 0%

Intensive blood pressure lowering in hypertensive patients with high arterial stiffness may lead to a greater decline in kidney function.

Cite This Study

Wang et al. (2026) conducted an RCT in hypertension (n=266). High arterial stiffness (tertile 3 baPWV) and intensive blood pressure lowering vs. Low arterial stiffness (tertile 1 baPWV) was evaluated on Kidney dysfunction (eGFR <60 ml/min·1.73 m2 or a decrease ≥30% from baseline) (OR 2.23, 95% CI 0.84-5.95). High arterial stiffness (tertile 3 vs 1) in hypertensive patients undergoing blood pressure lowering was associated with a higher incidence of kidney dysfunction (6.4% vs 0%; OR 2.23, 95% CI 0.84-5.95).

synapsesocial.com/papers/6a5b39118167787360d24ef4https://doi.org/10.1093/ajh/hpag088
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