ArticleAnnals of internal medicine2013
Blood pressure and mortality in U.S. veterans with chronic kidney disease: a cohort study.
Article in Annals of internal medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 108 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
BOLD: A Trial of Blood Pressure Lowering in Dialysis
Kidney Function in People With Cystic Fibrosis in the Era of HEMT
Who cites it
108 citing papers in PubMed, 5 syntheses or guidelines pooled it, 201 citations in OpenAlex.
- [Diabetic kidney disease (Update 2026) : Guidelines in a collaboration of the Austrian Diabetes Association and the Austrian Society of Nephrology].Wiener klinische Wochenschrift · 2026Guideline
- Circulating Osteoprotegerin Levels Independently Predict All-cause Mortality in Patients with Chronic Kidney Disease: a Meta-analysis.International journal of medical sciences · 2019Pooled it
- Association Between More Intensive vs Less Intensive Blood Pressure Lowering and Risk of Mortality in Chronic Kidney Disease Stages 3 to 5: A Systematic Review and Meta-analysis.JAMA internal medicine · 2017Pooled it
- 2014 Hypertension Guideline: Recommendation for a Change in Goal Systolic Blood Pressure.The Permanente journal · 2015Guideline
- Cardiovascular disease in CKD in 2013: Reducing cardiovascular risk--light at the end of the tunnel.Nature reviews. Nephrology · 2014Pooled it
- Impact of Renal Impairment on Intensive Blood-Pressure-Lowering Therapy and Outcomes in Intracerebral Hemorrhage: Results From ATACH-2.Neurology · 2021Trial
- Trial
- Vasculoprotective Effects of Dietary Cocoa Flavanols in Patients on Hemodialysis: A Double-Blind, Randomized, Placebo-Controlled Trial.Clinical journal of the American Society of Nephrology : CJASN · 2016Trial
- Association of BP with Death, Cardiovascular Events, and Progression to Chronic Dialysis in Patients with Advanced Kidney Disease.Clinical journal of the American Society of Nephrology : CJASN · 2015Trial
- Blood pressure and pulse pressure effects on renal outcomes in the Veterans Affairs Diabetes Trial (VADT).Diabetes care · 2014Trial
- BP, cardiovascular disease, and death in the Folic Acid for Vascular Outcome Reduction in Transplantation trial.Journal of the American Society of Nephrology : JASN · 2014Trial
- Intensive vs Standard Blood Pressure Lowering in People With and Without Chronic Kidney Disease: A Systematic Review and Meta-Analysis.JAMA cardiology · 2026Article
- Blood pressure and cardiovascular risk in adults with non-proteinuric chronic kidney disease without diabetes.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- MERWACS: Development and external validation of a non-invasive machine learning tool for identifying subjects to be screened for CKD.PLOS digital health · 2026Article
- Blood Pressure Control and Mortality Among US Veterans.Hypertension (Dallas, Tex. : 1979) · 2026Article
- A Comprehensive Review on the Efficacy of Antihypertensives in Patients With End-Stage Renal Disease.International journal of hypertension · 2026Review
- 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- A clinical trial evaluating pharmacist-guided self-management of hypertension among veterans with CKD, rationale and study design.Contemporary clinical trials · 2025Article
- Review
- Accuracy of 24 h ambulatory blood pressure recordings for diagnosing high 44 h blood pressure in hemodialysis: a diagnostic test study.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Article
48 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundThe ideal blood pressure (BP) to decrease mortality rates in patients with non-dialysis-dependent chronic kidney disease (CKD) is unclear.
objectiveTo assess the association of BP (defined as the combination of systolic BP [SBP] and diastolic BP [DBP] at the individual level) with death in patients with CKD.
designHistorical cohort between 2005 and 2012.
settingAll U.S. Department of Veterans Affairs health care facilities. PATIENTS: 651 749 U.S. veterans with CKD. MEASUREMENTS: All possible combinations of SBP and DBP were examined in 96 categories from lowest (<80/<40 mm Hg) to highest (>210/>120 mm Hg), in 10-mm Hg increments. Associations with all-cause mortality were examined in time-dependent Cox models with adjustment for relevant confounders.
resultsPatients with SBP of 130 to 159 mm Hg combined with DBP of 70 to 89 mm Hg had the lowest adjusted mortality rates, and 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. LIMITATION: Mostly male patients, inability to establish causality, and large number of patients missing proteinuria measurement.
conclusionThe optimal BP in patients with CKD seems to be 130 to 159/70 to 89 mm Hg. It may not be advantageous to achieve ideal SBP at the expense of lower-than-ideal DBP in adults with CKD. PRIMARY FUNDING SOURCE: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, and U.S. Department of Veterans Affairs.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.