New research, published today in the Journal of American Society of Nephrology by The George Institute for International Health in Sydney, has found that lowering blood pressure protects stroke victims with Chronic Kidney Disease from further strokes or heart attacks. Given the high risk of cardiovascular complications in people with Chronic Kidney Disease (CKD), these results have significant implications for millions of people across the world.
According to lead author, Dr Vlado Perkovic at The George Institute, most of the CKD population will die from cardiovascular complications. "People with Chronic Kidney Disease are at a significantly greater risk of cardiovascular events than those without the disease. We found that approximately twice as many cardiovascular events were prevented when a perindopril based blood pressure lowering regimen was used in these people, compared to people with normal kidney function."
The findings are based on a unique data set of around 1,800 patients who were part of a large clinical trial conducted on blood pressure and stroke, called PROGRESS. Dr Perkovic added that "The findings from PROGRESS have shifted the focus away from treating individuals with high blood pressure to focusing on those people at particularly high risk of heart disease and stroke. This research suggests that kidney function is an important parameter to consider in identifying these high risk individuals."
Chronic Kidney Disease (CKD) affects approximately one in six adults in Western Countries, and this proportion increases rapidly with increasing age. Over the last 25 years, while the Australian population has grown less than 40%, the number of Australians being treated with dialysis or a kidney transplant has grown more than 400%. Data from the Australian Bureau of statistics collected between 1997 and 1999 shows that approximately one in 10 death certificates listed kidney disease as the underlying or as an associated cause of death. The true contribution of kidney disease to premature mortality is likely to be significantly higher*.
Australia's annual spending on end stage kidney disease (ESKD) is $750 million, which is increasing by $50 million each year. This is just a small proportion of the total costs associated with kidney disease in this country.
PROGRESS was completed in 2001 and had a direct clinical impact for more than 50 million individuals with cerebrovascular disease worldwide. Results showed that blood pressure lowering reduced the risk of stroke by a quarter among patients with a history of cerebrovascular disease. Many further papers documenting the effects of treatment on other important outcomes, such as preventing heart attacks and the development of dementia, have now been published.
PROGRESS was funded by grants supplied by Servier, the Health Research Council of New Zealand, and the National Health and Medical Research Council of Australia.