Response by Peralta et al to Letter Regarding Article, “Effect of Intensive Versus Usual Blood Pressure Control on Kidney Function Among Individuals With Prior Lacunar Stroke: A Post Hoc Analysis of the Secondary Prevention of Small Subcortical Strokes (SPS3) Randomized Trial”
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We thank Dr Mezue and colleagues for their interest in our work. We agree that understanding the mechanisms to explain the differential associations of rapid decline with cardiovascular outcomes in the higher- versus lower-target blood pressure (BP) arms in SPS3 (Secondary Prevention of Small Subcortical Strokes) is important.1 The authors pose the hypothesis that differences in proteinuria levels over time may explain these observed differences. Although this remains a possibility, we are unable to make robust evidence-based conclusions with the current data because SPS3 did not include …