There was no clear evidence that proportional risk reductions in major cardiovascular disease differed by baseline disease history , except for diabetes and chronic kidney disease , for which smaller , but significant , risk reductions were detected .
β blockers were inferior to other drugs for the prevention of major cardiovascular disease events , stroke , and renal failure .
Calcium channel blockers were superior to other drugs for the prevention of stroke .
For the prevention of heart failure , calcium channel blockers were inferior and diuretics were superior to other drug classes .
INTERPRETATION Blood pressure lowering significantly reduces vascular risk across various baseline blood pressure levels and comorbidities .
BACKGROUND The benefits of blood pressure lowering treatment for prevention of cardiovascular disease are well established .
However , the extent to which these effects differ by baseline blood pressure , presence of comorbidities , or drug class is less clear .
We therefore performed a systematic review and meta- analysis to clarify these differences .
Prevalence of kidney damage in Australian adults: The AusDiab kidney study.
The incidence of ESRD is increasing dramatically . Progression to end-stage may be halted or slowed when kidney damage is detected at an early stage . Kidney damage is frequently asymptomatic but is indicated by the presence of proteinuria , hematuria , or reduced GFR . Population -based studies relating to the prevalence of kidney damage in the community are limited , particularly outside of the United States . Therefore , the prevalence of proteinuria , hematuria , and reduced GFR in the Australian adult population was determined using a cross-sectional study of 11,247 noninstitutionalized Australians aged 25 yr or over , r and omly selected using a stratified , cluster method . Subjects were interviewed and tested for  proteinuria-spot urine protein  to  creatinine ratio  ( abnormal : > /=0.20 mg/mg ) ; hematuria-spot urine dipstick ( abnormal : 1 + or greater ) confirmed by urine microscopy ( abnormal : > 10,000 red blood cells per milliliter ) or dipstick ( abnormal : 1 + or greater ) on midstream urine sample ; and reduced GFR-Cockcroft-Gault estimated GFR ( abnormal : < 60 ml/min per 1.73 m(2 ) ) . The associations between age , gender , diabetes mellitus , and hypertension , and indicators of kidney damage were examined . Proteinuria was detected in 2.4 % of cases ( 95 % CI : 1.6 % , 3.1 % ) , hematuria in 4.6 % ( 95 % CI : 3.8 % , 5.4 % ) , and reduced GFR in 11.2 % ( 95 % CI : 8.6 % , 13.8 % ) . Approximately 16 % had at least one indicator of kidney damage . Age , diabetes mellitus , and hypertension were independently associated with proteinuria ; age , gender , and hypertension with hematuria ; and age , gender , and hypertension with reduced GFR . Approximately 16 % of the Australian adult population has either proteinuria , hematuria , and /or reduced GFR , indicating the presence of kidney damage . Identifying and targeting this section of the population may provide a means to reduce the burden of ESRD
There was no clear evidence that proportional risk reductions in major cardiovascular disease differed by baseline disease history , except for diabetes and chronic kidney disease , for which smaller , but significant , risk reductions were detected .
β blockers were inferior to other drugs for the prevention of major cardiovascular disease events , stroke , and renal failure .
Calcium channel blockers were superior to other drugs for the prevention of stroke .
For the prevention of heart failure , calcium channel blockers were inferior and diuretics were superior to other drug classes .
INTERPRETATION Blood pressure lowering significantly reduces vascular risk across various baseline blood pressure levels and comorbidities .
BACKGROUND The benefits of blood pressure lowering treatment for prevention of cardiovascular disease are well established .
However , the extent to which these effects differ by baseline blood pressure , presence of comorbidities , or drug class is less clear .
We therefore performed a systematic review and meta- analysis to clarify these differences .