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5.3.8. Hypertension Treatment in Patients With Chronic
Kidney Disease
COR LOE
Recommendations
1 A
1. For adults with hypertension and CKD as identified by
eGFR <60 mL/min/1.73 m
2
or albuminuria ≥30 mg
albumin/g creatinine, treatment should target an SBP goal of
<130 mm Hg to decrease all-cause mortality.
1 B-R
2. For adults with hypertension and CKD as identified by eGFR
<60 mL/min/1.73 m
2
with albuminuria of ≥30 mg/g, RAASi
(either with ACEi or ARB but not both) is recommended to
decrease CVD and delay progression of kidney disease.
5.3.9. Cerebrovascular Disease
5.3.9.1. Acute Intracerebral Hemorrhage
COR LOE
Recommendations
2a A
1. For adult patients with acute spontaneous intracerebral
hemorrhage (ICH) who present with SBP between 150 and
220 mm Hg, it can be beneficial to immediately lower SBP to
130 to <140 mm Hg for at least 7 days after ICH to improve
functional outcomes but stop antihypertensive medications if
SBP <130 mm Hg.
2a B-NR
2. In adults with acute spontaneous ICH requiring acute BP
lowering, careful titration to ensure smooth, nonlabile, and
sustained control of BP, avoiding peaks and large variability
in SBP, can be beneficial for improving functional outcomes.
3: Harm B-NR
3. For adult patients with acute spontaneous ICH who present
with SBP >220 mm Hg, SBP should not be lowered below
130 mm Hg to reduce adverse events.
