What evidence is there to guide a recommendation for patients with diabetes and CKD in terms of SBP lowering?
There is limited direct evidence from the ACCORD trial to guide a recommendation for patients with diabetes and CKD. However, there was no statistical interaction between CKD and intensive BP lowering on the reduction in stroke risk. Additionally, a post hoc analysis of SPRINT found that the CV and survival benefits of intensive SBP reduction (<120 mm Hg) were similar in those with and without prediabetes. Furthermore, a combined post hoc analysis of SPRINT and ACCORD suggested similar CV benefits of intensive BP-lowering therapy in the presence or absence of diabetes.