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Editor's Correspondence |

Achieved vs Initial Blood Pressure in Predicting Renal Outcomes—Reply

George L. Bakris, MD
Arch Intern Med. 2004;164(2):223-224. doi:10.1001/archinte.164.2.223-b.
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My colleagues and I thank Dr Onuigbo for his insightful comments regarding our article.1 In this article, we assessed the importance of baseline and treated BP on progression of renal disease. The results of this post hoc analysis demonstrate that higher values of both baseline and achieved SBPs were associated with increased risk for renal outcomes. We further explored the predictive nature of baseline SBP with a multivariate Cox model when relevant. Baseline risk factors such as proteinuria, serum creatinine, serum albumin, hemoglobin A1C, and hemoglobin levels were considered. In this multivariate model, the increased risk for renal outcomes as a function of SBP was diminished when accounting for these variables; nevertheless, SBP is still a significant risk factor in that for every 10–mm Hg rise in baseline SBP, the risk for ESRD or death increased by 6.7% (P= .007).1

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