The OSCAR for cardiovascular disease prevention in chronic kidney disease goes to blood pressure control.

Nephropathy progression is slowed and cardiovascular events reduced in patients with stage 3 or higher chronic kidney disease when blood pressure is controlled using combinations of renin-angiotensin system (RAS) blockers with dihydropyridine calcium channel blockers or diuretics. We discuss a trial comparing high-dose RAS blockade with lower-dose RAS blockade combined with a dihydropyridine calcium channel blocker. The primary outcome was cardiovascular events. The combination group had better blood pressure control and fewer total events.