To evaluate the effects of intensive blood pressure control on major adverse cardiovascular events across stages II to IV of cardiovascular-kidney-metabolic syndrome.
Key Findings:
Intensive therapy was associated with a reduced frequency of the primary composite outcome.
Stroke contributed the largest absolute risk reduction within the composite outcome.
Net clinical benefit was observed across all CKM syndrome stages.
All-cause mortality was reduced in stages II and III but not in stage IV.
Hypotension occurred more frequently in the intensive treatment group.
Interpretation:
Intensive blood pressure control may provide significant cardiovascular benefits across various stages of cardiovascular-kidney-metabolic syndrome, although the risk of hypotension should be monitored.
Limitations:
Findings are susceptible to residual confounding despite statistical adjustments.
CKM syndrome stages were assigned without imaging or biomarker confirmation, potentially affecting classification accuracy.
The study was limited to rural primary care settings, which may not be generalizable to urban environments.
Conclusion:
Intensive blood pressure management can reduce major cardiovascular events in patients with hypertension across CKM stages, but careful consideration of potential adverse effects is necessary.
