On-treatment systolic blood pressure and preserved kidney function in hypertensive patients with proteinuria. The VALUE Trial

Olsen E, Mariampillai JE, Schmieder R, Jamerson K, Søraas CL, Mancia G, Mehlum MH, Liestøl K, Larstorp AC, Halvorsen LV, Waldum-Grevbo B, Mo R, Kjeldsen SE, Weber MA (2025)

Publication Type: Journal article

Publication year: 2025

Journal

Blood Pressure Informa Healthcare

Book Volume: 34

Pages Range: 2544715-

Journal Issue: 1

DOI: 10.1080/08037051.2025.2544715

Abstract

AIMS: We investigated on-treatment systolic BP (SBP) <130, 130-139 and ≥140 mmHg related to nephroprotection in 3065 patients with proteinuria and 10,738 patients without proteinuria in the VALUE Trial. METHOD AND RESULTS: Worsened kidney function (WKF) was ≥50% increase in serum creatinine, and end-stage kidney disease (ESKD) was dialysis/transplantation. Cox proportional hazards models were adjusted for covariates in the on-treatment SBP groups. Lower SBP was significantly related to less WKF (p < .001) in patients with proteinuria, both at <130 mmHg (n = 14/529, 2.6%) and 130-139 mmHg (n = 46/1176, 3.9%) compared to ≥140 mmHg (n = 145/1358, 10.7%). None of the 532 patients with proteinuria had ESKD at <130 mmHg, and only 11/1194 (0.9%) at 130-139 mmHg (p = .098) compared to 39/1339 (2.9%) at SBP ≥ 140 mmHg. In patients without proteinuria the relation between lower SBP and WKF was not significant (p = .23) at <130 mmHg (n = 24/1927, 1.2%) but significant (p = .04) at 130-139 mmHg (n = 74/4611, 1.6%) compared to SBP ≥ 140 mmHg (n = 117/4199, 2.8%). ESKD was 0.2%, 0.2% and 0.4% in the SBP groups, respectively. WKF fell from 12.1% in Q1 (highest SBP quartile) to 6.1% in Q2 (p = .023), 4.2% in Q3 (p = .006) and 2.8% in Q4 (p < .001) in patients with proteinuria and ESKD from 3.5% (Q1) to 1.6% (Q2) (p = .13), 0.7% (Q3) (p = .027) and 0.1% in Q4 (p = .009). In the patients without proteinuria, neither WKF nor ESKD showed statistically significant changes between SBP quartiles. CONCLUSIONS: Our data suggest that, compared to SBP ≥ 140 mmHg, on-treatment SBP <130 and 130-139 mmHg were strongly related to nephroprotection in hypertensive patients with proteinuria.

Authors with CRIS profile

Roland Schmieder Medizinische Fakultät

Involved external institutions

NTNU Trondheim - Norwegian University of Science and Technology NO Norway (NO) University of Michigan US United States (USA) (US) SUNY Downstate Health Sciences University US United States (USA) (US) University of Oslo NO Norway (NO) Oslo University Hospital / Oslo Universitetssykehus Rikshospitalet NO Norway (NO) University of Milano-Bicocca / Università degli Studi di Milano-Bicocca, UNIMIB IT Italy (IT) Akershus University Hospital / Akershus universitetssykehus (Ahus) NO Norway (NO)

How to cite

APA:

Olsen, E., Mariampillai, J.E., Schmieder, R., Jamerson, K., Søraas, C.L., Mancia, G.,... Weber, M.A. (2025). On-treatment systolic blood pressure and preserved kidney function in hypertensive patients with proteinuria. The VALUE Trial. Blood Pressure, 34(1), 2544715-. https://doi.org/10.1080/08037051.2025.2544715

MLA:

Olsen, Eirik, et al. "On-treatment systolic blood pressure and preserved kidney function in hypertensive patients with proteinuria. The VALUE Trial." Blood Pressure 34.1 (2025): 2544715-.

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