Evidence map›Paper›PMID 40542174›Full record

SynthesisHypertension research : official journal of the Japanese Society of Hypertension2025

Evaluating blood pressure targets in chronic kidney disease: a systematic review and meta-analysis.

Kazuhiro Tada, Akira Fujiwara, Naoki Sugano, Kaori Hayashi, Atsushi Sakima, Yoichi Takami, Kosuke Masutani, Hisatomi Arima, Shuji Arima, Naoki Nakagawa

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Hypertension research : official journal of the Japanese Society of Hypertension, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Blood pressure targets for hypertension in people with diabetes mellitus.The Cochrane database of systematic reviews · 2026
    Pooled it
  2. Pooled it
  3. Review
  4. Review
  5. Article
  6. Article
  7. Advancing evidence-based blood pressure targets in JSH2025.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  8. Blood pressure control in patients with chronic kidney disease: comparison between JSH2025 and other international guidelines.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  9. Article
  10. The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  11. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Kazuhiro TadaDivision of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan. ktada@fukuoka-u.ac.jp.
Akira FujiwaraDepartment of Nephrology and Hypertension, Yokohama City University Medical Center, Yokohama, Japan.
Naoki SuganoDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Kaori HayashiDivision of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Atsushi SakimaHealth Administration Center, University of the Ryukyus, Nishihara, Japan.
Yoichi TakamiDepartment of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
Kosuke MasutaniDivision of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Hisatomi ArimaDepartment of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Shuji ArimaDivision of Nephrology, Department of Internal Medicine, Kindai University Faculty of Medicine, Osaka, Japan.
Naoki NakagawaDivision of Cardiology and Nephrology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Many studies have investigated optimal blood pressure (BP) targets in patients with chronic kidney disease (CKD); however, no consensus has been reached. We therefore conducted a systematic review and meta-analysis, including the latest randomized controlled trials (RCTs). We searched MEDLINE, the Cochrane Library, and Ichushi Web for publications up to 13 June 2024, supplemented by hand searches. We included RCTs comparing the benefits and risks of more intensive (target BP: <130/80 mmHg) versus less intensive BP control (target BP: 130-149/80-89 mmHg or usual care) in patients with CKD aged ≥18 years, regardless of diabetes status. Primary outcomes were all-cause mortality and cardiovascular events. Secondary outcomes included renal events, including 50% reduction in estimated glomerular filtration rate (eGFR)/GFR, and end-stage kidney disease (ESKD). We calculated the risk ratio (RR) and variance, and obtained summary estimates of the effects with 95% confidence intervals (CIs) using a random-effects model with inverse variance weighting. Our meta-analysis included nine RCTs. More intensive BP control tended to reduce all-cause mortality (RR = 0.81; 95% CI 0.65-1.00; p = 0.051) and cardiovascular events (RR = 0.89; 95% CI 0.77-1.03; p = 0.13), but the differences were not significant. More intensive BP control did not increase the risk of serious renal events, including 50% reduction in eGFR/GFR (RR = 0.95; 95% CI 0.74-1.22; p = 0.69) or progression to ESKD (RR = 0.92; 95% CI 0.75-1.14; p = 0.45). These findings suggest that intensive BP control targeting <130/80 mmHg may reduce the risk of all-cause mortality and cardiovascular events in patients with CKD, without increasing the risk of serious renal events. This meta-analysis of nine RCTs in patients with CKD found that more intensive BP control tended to reduce all-cause mortality and CVD events compared with less intensive control, without increasing serious kidney events, including 50% eGFR/GFR reduction, or ESKD.

Indexed as

Antihypertensive AgentsBlood PressureHypertensionRenal Insufficiency, ChronicGlomerular Filtration RateHumansRandomized Controlled Trials as TopicAntihypertensive AgentsBlood pressure targetCardiovascular eventIntensive blood pressure loweringKidney disease progressionMortality

Identifiers

PMID40542174

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.