New Hypertension Targets Improve Patient and Graft Survival

San Diego—Utilizing data from SPRINT (Systolic Blood pressure Intervention Trial), American national guidelines reduced the blood pressure goal from 140.90 mm Hg to 130/80 mm HG for subjects with increased cardiovascular risk, including patients with chronic kidney disease (CKD). There are few data available on whether renal transplant recipients benefit from the reduced blood pressure goals.

Nikolaos Pagonas, MD, and colleagues recently conducted a retrospective analysis of patients who underwent renal transplant in three transplant centers in Germany between 1997 and 2011. The study included 877 patients with a follow-up of 12 to 120 months. The composite end point was patient and graft survival. Results were reported during a poster session at Kidney Week 2018 in a poster titled Application of New Hypertension Guidelines to Renal Transplant Recipients: Impact on Cardiovascular Outcome and Graft Survival.

Blood pressure measurement was obtained at regular follow-up examinations at the transplant center. Patients were stratified according to mean systolic blood pressure values <130 mm Hg, 130 to 139 mm Hg, or ≥140 mm Hg.

During the overall follow-up period, there was a significant association between mean systolic blood pressure and the composite end point. Compared with patients with systolic blood pressure 130 to 140 mm Hg, cumulative survival was significantly higher for the patients with systolic blood pressure <130 mm Hg. Survival was lowest in the group of renal transplant recipients with a mean systolic blood pressure ≥140 mm Hg.

Analogously, there was an association between mean systolic blood pressure of the first 12 months post-transplant <130 mm Hg and better cumulative patient and graft survival versus higher blood pressure values in Kaplan Maier analyses.

“Renal transplant recipients who achieve a mean systolic blood pressure <130 mm Hg have a significantly lower mortality and a better allograft outcome than with the conservative blood pressure <140 mm Hg. The new blood pressure targets should be considered suitable for renal transplant recipients as well,” the researchers said.

Source: Pagonas N, Seibert FS, Bauer F, et al. Application of new hypertension guidelines to renal transplant recipients: Impact on cardiovascular outcome and graft survival. Abstract of a poster (TH-PO128) presented at the American Society of Nephrology Kidney Week 2018, October 25, 2018, San Diego, California.