- Antihypertensive therapy and statins appear to have a synergistic effect in lowering mortality risk that transcends cholesterol reduction among patients with nondiabetic chronic kidney disease (CKD).
Why this matters
- The survival benefit was greater than that observed in the original SPRINT CKD study, which found a 28% reduced risk for all-cause mortality.
- Other studies have pointed to statin benefits beyond cholesterol lowering.
- Post hoc analysis of the SPRINT trial, focusing on 2646 patients with CKD (stage IIIa, 66%; IIIb, 28%; IV, 6%) randomly assigned to an intensive (
- 51.2% were receiving a statin, 48.1% were not, and status was unknown for the remainder (n=19).
- Median follow-up, 3.26 years.
- Funding: None disclosed.
- Statins + intensive systolic blood pressure (SBP) targeting yielded a 56% reduced risk for all-cause mortality (1.16 vs 2.5 per 100 patient-years [PY]: aHR=0.44; P=.009).
- Statins + intensive SBP targeting yielded a 71% lower risk for cardiovascular mortality (0.28 vs 0.92 per 100 PY: aHR=0.29; P=.021).
- Without statins, there was no difference between intensive and standard SBP targeting on all-cause (2.01 vs 1.94 per 100 PY) or cardiovascular mortality (0.52 vs 0.41 per 100 PY).
- Nonrandomized statin use, captured only at baseline.
- Diabetic patients excluded.