As guidelines now recommend intensive blood pressure (BP) lowering targets, more patients are being started on intensive BP regimens, which often include renin-angiotensin-aldosterone system (RAS) blockade. Our results suggest that the relation between mild acute estimated glomerular filtration rate (eGFR) declines after starting these regimens and risk of kidney failure was different depending upon BP target intensity, rather than depending upon the inclusion or not of a RAS-blocking agent.