Rowan-Virtua School of Osteopathic Medicine Maple Shade, New Jersey
Background and Hypothesis: Limited studies have been conducted analyzing blood pressure goals and their effect on the progression of Chronic Kidney Disease (CKD). With varying guidelines for blood pressure goals and diabetic renal disease, this study aimed to determine if more intensive blood pressure control on the progression of CKD would outweigh any adverse effects. We hypothesized that individuals with an intensive blood pressure goal of < 130/80 will have no significant difference in their incidence and progression of CKD compared to individuals with a standard blood pressure goal of < 140/90.
Methods: A retrospective chart review was performed compiling a database of relevant lab values and blood pressures from adults with type 1 and type 2 diabetes between ages 18 and 70 from Rowan Family Medicine clinics in New Jersey between two office visits from 2017- 2018 and 2021-2022. Specific data points were compiled including systolic blood pressure, diastolic blood pressure, hemoglobin A1c, and estimated glomerular filtration rate (eGFR). From a sample size of 1218 adults with diabetes, those with missing blood pressure or eGFR values were excluded. The dataset included 150 patients in the standard group and 331 patients in the intensive group. Statistical analysis assessed if a significant correlation exists between a specific cutoff for blood pressure values and decline in renal function using a standard blood pressure group (BP < 140/90) and an intensive blood pressure goal (BP < 130/80).
Results: Two sample t-test suggested no statistically significant difference in the decline in renal function in patients with intensive blood pressure control and standard blood pressure control (p=0.78).
Conclusion: The data portrays no difference in decline in renal function between those with intensive blood pressure control and those with standard blood pressure control. This supports that a more intensive blood pressure goal may not be necessary to decrease the risk of renal disease secondary to diabetes.
Acknowledgement of Research Study Sponsors and IRB: We are thankful to Rowan Family Medicine for their contribution to this study and the Institutional Review Board of Rowan University for approving this study.
