What does this research mean for the field?

The effects of intensive blood pressure control are modified by baseline KDIGO risk, with cardiovascular benefits attenuated and adverse kidney events increased primarily in lower-risk rather than higher-risk patients. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine how intensive systolic blood pressure lowering affects cardiovascular and kidney outcomes across baseline KDIGO risk categories.

September 5, 2026Hypertension Research

Intensive BP control is linked to ~32% fewer CV events but increased adverse kidney events.

Q: What is the clinical evidence from this study?

Study design: Other. Population: Cardiovascular and kidney risk in hypertension. Intervention: Intensive blood pressure control. Primary outcome: Composite adverse CV events (nonfatal MI, nonfatal stroke, fatal or hospitalized HF, and CV mortality) and composite adverse kidney events (sustained decline in eGFR of ≥ 40% and ESKD) (HR 0.68, 95% CI 0.59-0.78).

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Why the study?

Does intensive systolic blood pressure control reduce cardiovascular events and affect kidney outcomes across different KDIGO risk categories in patients from the SPRINT and ACCORD-BP trials?

Population

Participants from the SPRINT and SPRINT-eligible ACCORD-BP trials, categorized into low, moderate, and…

Design

Cohort

Key result

Intensive blood pressure control reduced composite CV events (HR 0.68; 95% CI 0.59-0.78) but increased composite kidney events (HR 1.88; 95% CI 1.52-2.33), with effects modified by KDIGO risk.

Authors

XMXi Meng YWYueyue Wang YXYu Xiang

Discussion

Member takes

Overview

Intensive BP control may reduce CV events at kidney event cost by KDIGO risk; leaves open individualized targets in prospective trials.

Key Points

To determine how intensive systolic blood pressure lowering affects cardiovascular and kidney outcomes across baseline KDIGO risk categories.
Secondary analysis pooling data from two randomized clinical trials: SPRINT (NCT01206062) and SPRINT-eligible participants from ACCORD-BP (NCT00000620).
Participants were stratified into low, moderate, and high/very-high KDIGO risk groups to evaluate primary composite cardiovascular outcomes and composite adverse kidney events.
Intensive blood pressure control significantly reduced composite cardiovascular events (HR 0.68; 95% CI 0.59–0.78), with attenuated protection in higher KDIGO risk categories (P for interaction = 0.055).
Intensive management increased the risk of composite kidney events (HR 1.88; 95% CI 1.52–2.33), which occurred predominantly in low- and moderate-risk groups (P for interaction = 0.04) and was driven by sustained eGFR decline (P for interaction = 0.03) rather than end-stage kidney disease (HR 1.05; 95% CI 0.74–1.48; P for interaction = 0.71).

Structured PICO

Does intensive systolic blood pressure control reduce cardiovascular events and affect kidney outcomes across different KDIGO risk categories in patients from the SPRINT and ACCORD-BP trials?

Population

Participants from the SPRINT and SPRINT-eligible ACCORD-BP trials categorized by KDIGO risk to evaluate the effects of intensive blood pressure control.

Intervention

Intensive systolic blood pressure (SBP) control

Outcome

Composite adverse CV events (nonfatal MI, nonfatal stroke, fatal or hospitalized HF, and CV mortality) and composite adverse kidney events (sustained decline in eGFR of ≥ 40% and ESKD)composite

Main Result

Hazard Ratio: 0.68 (95% CI 0.59–0.78)

Intensive blood pressure control reduces cardiovascular events but increases kidney events, highlighting the need to balance these competing risks based on a patient's baseline KDIGO risk category.

Cite This Study

Meng et al. (2026) studied Cardiovascular and kidney risk in hypertension. Intensive blood pressure control was evaluated on Composite adverse CV events (nonfatal MI, nonfatal stroke, fatal or hospitalized HF, and CV mortality) and composite adverse kidney events (sustained decline in eGFR of ≥ 40% and ESKD) (HR 0.68, 95% CI 0.59-0.78). Intensive blood pressure control reduced composite CV events (HR 0.68; 95% CI 0.59-0.78) but increased composite kidney events (HR 1.88; 95% CI 1.52-2.33), with effects modified by KDIGO risk.

synapsesocial.com/papers/6a9c01406b95aff0620ec813 https://doi.org/10.1038/s41440-026-02792-5

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September 5, 2026Hypertension Research

Intensive BP control is linked to ~32% fewer CV events but increased adverse kidney events.

View Full Paper

Ask AI

Bookmark

Why the study?

Does intensive systolic blood pressure control reduce cardiovascular events and affect kidney outcomes across different KDIGO risk categories in patients from the SPRINT and ACCORD-BP trials?

Population

Participants from the SPRINT and SPRINT-eligible ACCORD-BP trials, categorized into low, moderate, and…

Design

Cohort

Key result

Intensive blood pressure control reduced composite CV events (HR 0.68; 95% CI 0.59-0.78) but increased composite kidney events (HR 1.88; 95% CI 1.52-2.33), with effects modified by KDIGO risk.

Authors

XMXi Meng YWYueyue Wang YXYu Xiang

Discussion

Member takes

Overview

Intensive BP control may reduce CV events at kidney event cost by KDIGO risk; leaves open individualized targets in prospective trials.

Key Points

To determine how intensive systolic blood pressure lowering affects cardiovascular and kidney outcomes across baseline KDIGO risk categories.
Secondary analysis pooling data from two randomized clinical trials: SPRINT (NCT01206062) and SPRINT-eligible participants from ACCORD-BP (NCT00000620).
Participants were stratified into low, moderate, and high/very-high KDIGO risk groups to evaluate primary composite cardiovascular outcomes and composite adverse kidney events.
Intensive blood pressure control significantly reduced composite cardiovascular events (HR 0.68; 95% CI 0.59–0.78), with attenuated protection in higher KDIGO risk categories (P for interaction = 0.055).
Intensive management increased the risk of composite kidney events (HR 1.88; 95% CI 1.52–2.33), which occurred predominantly in low- and moderate-risk groups (P for interaction = 0.04) and was driven by sustained eGFR decline (P for interaction = 0.03) rather than end-stage kidney disease (HR 1.05; 95% CI 0.74–1.48; P for interaction = 0.71).

Structured PICO

Does intensive systolic blood pressure control reduce cardiovascular events and affect kidney outcomes across different KDIGO risk categories in patients from the SPRINT and ACCORD-BP trials?

Population

Participants from the SPRINT and SPRINT-eligible ACCORD-BP trials categorized by KDIGO risk to evaluate the effects of intensive blood pressure control.

Intervention

Intensive systolic blood pressure (SBP) control

Outcome

Composite adverse CV events (nonfatal MI, nonfatal stroke, fatal or hospitalized HF, and CV mortality) and composite adverse kidney events (sustained decline in eGFR of ≥ 40% and ESKD)composite

Main Result

Hazard Ratio: 0.68 (95% CI 0.59–0.78)

Intensive blood pressure control reduces cardiovascular events but increases kidney events, highlighting the need to balance these competing risks based on a patient's baseline KDIGO risk category.

Cite This Study

synapsesocial.com/papers/6a9c01406b95aff0620ec813 https://doi.org/10.1038/s41440-026-02792-5

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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