To the Editor Maintaining optimal blood pressure in patients without diabetes with chronic kidney disease (CKD) has always been controversial. In a systematic review and meta-analysis published in a recent issue of JAMA Internal Medicine, Tsai et al¹ assessed the clinical data of 8127 patients; they focused on detecting an association between intensive blood pressure control and renal outcomes in patients without diabetes with CKD. Consequently, no significant difference in major renal outcomes was found between intensive (<130/80 mm Hg) and standard BP control (<140/90 mm Hg) groups during a median follow-up of 3.3 years. Nevertheless, nonblack patients or those with higher levels of proteinuria were found to benefit from the intensive BP-lowering strategy.

致编者 对于患有慢性肾脏疾病（CKD）的非糖尿病患者维持最佳血压一直存在争议。在最近一期的《JAMA内科杂志》上发表的系统评价和荟萃分析中，Tsai等[ ^1]评估了8127例患者的临床数据。他们专注于检测无CKD糖尿病患者的强化血压控制与肾脏预后之间的关系。因此，在3.3年的中位随访期间，强化组（<130/80 mm Hg）和标准血压控制组（<140/90 mm Hg）之间在主要肾结局方面没有发现显着差异。然而，发现非黑人患者或蛋白尿水平较高的患者可从强化降压策略中受益。