This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (360)  • Contact me when this article is cited  Related Content  • Related letter  • Related articles  • Similar articles in JAMA  Topic Collections  • Renal Diseases  • Acute Renal Failure  • Randomized Controlled Trial  • Hypertension  • Alert me on articles by topic  Social Bookmarking   What's this?

A Randomized Controlled Trial

Lawrence Y. Agodoa, MD; Lawrence Appel, MD,MPH; George L. Bakris, MD; Gerald Beck, PhD; Jacques Bourgoignie, MD; Josephine P. Briggs, MD; Jeanne Charleston, RN; DeAnna Cheek, MD; William Cleveland, MD; Janice G. Douglas, MD; Margaret Douglas, MPH; Donna Dowie, MD; Marquetta Faulkner, MD; Avril Gabriel, RN; Jennifer Gassman, PhD; Tom Greene, PhD; Yvette Hall, RN; Lee Hebert, MD; Leena Hiremath, PhD; Kenneth Jamerson, MD; Carolyn J. Johnson, RN; Joel Kopple, MD; John Kusek, PhD; James Lash, MD; Janice Lea, MD; Julia B. Lewis, MD; Michael Lipkowitz, PhD; Shaul Massry, MD; John Middleton, MD; Edgar R. Miller III, MD; Keith Norris, MD; Daniel O'Connor, MD; Akinlou Ojo, MD; Robert A. Phillips, MD,PhD; Velvie Pogue, MD; Mahboob Rahman, MD,MS; Otelio S. Randall, MD; Stephen Rostand, MD; Gerald Schulman, MD; Winifred Smith, MPH; Denyse Thornley-Brown, MD; C. Craig Tisher, MD; Robert D. Toto, MD; Jackson T. Wright, Jr, MD,PhD; Shichen Xu, MD; for the African American Study of Kidney Disease and Hypertension (AASK) Study Group

JAMA. 2001;285:2719-2728.

Context  Incidence of end-stage renal disease due to hypertension has increased in recent decades, but the optimal strategy for treatment of hypertension to prevent renal failure is unknown, especially among African Americans.

Objective  To compare the effects of an angiotensin-converting enzyme (ACE) inhibitor (ramipril), a dihydropyridine calcium channel blocker (amlodipine), and a -blocker (metoprolol) on hypertensive renal disease progression.

Design, Setting, and Participants  Interim analysis of a randomized, double-blind, 3 x 2 factorial trial conducted in 1094 African Americans aged 18 to 70 years with hypertensive renal disease (glomerular filtration rate [GFR] of 20-65 mL/min per 1.73 m²) enrolled between February 1995 and September 1998. This report compares the ramipril and amlodipine groups following discontinuation of the amlodipine intervention in September 2000.

Interventions  Participants were randomly assigned to receive amlodipine, 5 to 10 mg/d (n = 217), ramipril, 2.5 to 10 mg/d (n = 436), or metoprolol, 50 to 200 mg/d (n = 441), with other agents added to achieve 1 of 2 blood pressure goals.

Main Outcome Measures  The primary outcome measure was the rate of change in GFR; the main secondary outcome was a composite index of the clinical end points of reduction in GFR of more than 50% or 25 mL/min per 1.73 m², end-stage renal disease, or death.

Results  Among participants with a urinary protein to creatinine ratio of >0.22 (corresponding approximately to proteinuria of more than 300 mg/d), the ramipril group had a 36% (2.02 [SE, 0.74] mL/min per 1.73 m²/y) slower mean decline in GFR over 3 years (P = .006) and a 48% reduced risk of the clinical end points vs the amlodipine group (95% confidence interval [CI], 20%-66%). In the entire cohort, there was no significant difference in mean GFR decline from baseline to 3 years between treatment groups (P = .38). However, compared with the amlodipine group, after adjustment for baseline covariates the ramipril group had a 38% reduced risk of clinical end points (95% CI, 13%-56%), a 36% slower mean decline in GFR after 3 months (P = .002), and less proteinuria (P<.001).

Conclusion  Ramipril, compared with amlodipine, retards renal disease progression in patients with hypertensive renal disease and proteinuria and may offer benefit to patients without proteinuria.

Author Affiliations: National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md (Drs Agodoa, Briggs, and Kusek); Department of Preventive Medicine, Johns Hopkins University, Baltimore, Md (Drs Appel and Miller and Ms Charleston); Department of Preventive Medicine, Rush-Presbyterian-St Luke's Medical Center, Chicago, Ill (Dr Bakris); Department of Biostatistics, Cleveland Clinic Foundation, Cleveland, Ohio (Drs Beck, Gassman, and Greene); Department of Medicine, University of Miami, Coral Gables, Fla (Dr Bourgoignie); Department of Medicine, Medical University of South Carolina, Charleston (Dr Cheek); Department of Medicine, Morehouse School of Medicine, Atlanta, Ga (Dr Cleveland and Mr Smith); Department of Medicine, Case Western Reserve University Hospitals, Cleveland, Ohio (Drs Douglas, Rahman, and Wright, and Ms Hall); Department of Medicine, Emory University Medical Center, Atlanta, Ga (Ms Douglas and Dr Lea); Department of Medicine, Harlem Hospital Center, New York, NY (Drs Dowie and Pogue); Department of Medicine, Meharry Medical College, Nashville, Tenn (Dr Faulkner); Department of Medicine, Mount Sinai School of Medicine, New York, NY (Ms Gabriel and Drs Lipkowitz and Phillips); Department of Medicine, Ohio State University, Columbus (Drs Hebert and Hiremath); Department of Medicine, University of Michigan, Ann Arbor (Drs Jamerson and Ojo); Department of Medicine, Harbor Medical Center, University of California, Los Angeles (Dr Kopple); Department of Medicine, University of Illinois, Chicago (Dr Lash); Department of Medicine, Vanderbilt University, Nashville, Tenn (Drs Lewis and Schulman); Department of Medicine, University of Southern California, Los Angeles (Dr Massry); Department of Medicine, University of Texas Southwestern Medical Center, Dallas (Drs Middleton and Toto); Department of Medicine, Martin L. King–Charles R. Drew Medical Center, Los Angeles, Calif (Dr Norris); Department of Medicine, University of California, San Diego (Dr O'Connor); Department of Medicine, Howard University, Washington, DC (Drs Randall and Xu); Department of Medicine, University of Alabama, Birmingham (Drs Rostand and Thornley-Brown and Ms Johnson); Department of Medicine, University of Florida, Gainesville (Dr Tisher); and Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio (Dr Wright).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTER

Antihypertensive Drugs and Renal Protection
Michio Fukuda, Takeshi Usami, Atsuhiro Yoshida, and Genjiro Kimura
JAMA. 2003;289(9):1102-1103.
EXTRACT | FULL TEXT  

RELATED ARTICLES

Selection of Antihypertensive Therapy for Patients With Hypertensive Renal Disease
Vasilios Papademetriou
JAMA. 2001;285(21):2774-2776.
EXTRACT | FULL TEXT  

June 6, 2001
JAMA. 2001;285(21):2793-2794.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Adrenergic beta-1 receptor genetic variation predicts longitudinal rate of GFR decline in hypertensive nephrosclerosis
Fung et al.
Nephrol Dial Transplant 2009;24:3677-3686.
ABSTRACT | FULL TEXT  

Dual blockade of the renin-angiotensin system: are two better than one?
Haynes et al.
Nephrol Dial Transplant 2009;24:3602-3607.
FULL TEXT  

Not so free associations
Luft
Nephrol Dial Transplant 2009;24:3576-3577.
FULL TEXT  

Beyond office sphygmomanometry: Ways to better assess blood pressure
RAFEY
Cleveland Clinic Journal of Medicine 2009;76:657-662.
ABSTRACT | FULL TEXT  

Serum Alkaline Phosphatase and Mortality in African Americans with Chronic Kidney Disease
Beddhu et al.
CJASN 2009;4:1805-1810.
ABSTRACT | FULL TEXT  

Risk of Hyperkalemia in Nondiabetic Patients With Chronic Kidney Disease Receiving Antihypertensive Therapy
Weinberg et al.
Arch Intern Med 2009;169:1587-1594.
ABSTRACT | FULL TEXT  

Chromogranin A Regulates Renal Function by Triggering Weibel-Palade Body Exocytosis
Chen et al.
J. Am. Soc. Nephrol. 2009;20:1623-1632.
ABSTRACT | FULL TEXT  

Acetaminophen, aspirin and progression of advanced chronic kidney disease
Evans et al.
Nephrol Dial Transplant 2009;24:1908-1918.
ABSTRACT | FULL TEXT  

The effect of n-3 long-chain polyunsaturated fatty acid supplementation on urine protein excretion and kidney function: meta-analysis of clinical trials
Miller et al.
Am. J. Clin. Nutr. 2009;89:1937-1945.
ABSTRACT | FULL TEXT  

Current Guidelines for Using Angiotensin-Converting Enzyme Inhibitors and Angiotensin II-Receptor Antagonists in Chronic Kidney Disease: Is the Evidence Base Relevant to Older Adults?
O'Hare et al.
ANN INTERN MED 2009;150:717-724.
ABSTRACT | FULL TEXT  

Blood Pressure Components and the Risk for End-Stage Renal Disease and Death in Chronic Kidney Disease
Agarwal
CJASN 2009;4:830-837.
ABSTRACT | FULL TEXT  

Are We Ready to Screen the General Population for Microalbuminuria?
Fried
J. Am. Soc. Nephrol. 2009;20:686-688.
FULL TEXT  

CHAPTER 13 Hypertension
Kjeldsen et al.
ESC Textbook of Cardiovascular Medicine 2009;2:med-9780199566990-chapter-med-9780199566990-chapter.
ABSTRACT | FULL TEXT  

Hypertension-Associated Kidney Disease: Perhaps no More
Freedman and Sedor
J. Am. Soc. Nephrol. 2008;19:2047-2051.
ABSTRACT | FULL TEXT  

Association of a CYP4A11 Variant and Blood Pressure in Black Men
Gainer et al.
J. Am. Soc. Nephrol. 2008;19:1606-1612.
ABSTRACT | FULL TEXT  

Best Practices for Lowering the Risk of Cardiovascular Disease in Diabetes
Triplitt and Alvarez
Diabetes Spectr. 2008;21:177-189.
ABSTRACT | FULL TEXT  

Racial Analysis of Patients With Myocardial Infarction Complicated by Heart Failure and/or Left Ventricular Dysfunction Treated With Valsartan, Captopril, or Both
Prisant et al.
J Am Coll Cardiol 2008;51:1865-1871.
ABSTRACT | FULL TEXT  

Long-term Effects of Renin-Angiotensin System-Blocking Therapy and a Low Blood Pressure Goal on Progression of Hypertensive Chronic Kidney Disease in African Americans
Appel et al.
Arch Intern Med 2008;168:832-839.
ABSTRACT | FULL TEXT  

Principles of Screening for Chronic Kidney Disease
Jaar et al.
CJASN 2008;3:601-609.
FULL TEXT  

Management of Cardiovascular Disease in Renal Transplant Recipients
Shirali and Bia
CJASN 2008;3:491-504.
ABSTRACT | FULL TEXT  

Chromogranin A Polymorphisms Are Associated With Hypertensive Renal Disease
Salem et al.
J. Am. Soc. Nephrol. 2008;19:600-614.
ABSTRACT | FULL TEXT  

Cardiovascular Disease in Transplant Recipients: Current and Future Treatment Strategies
Gill
CJASN 2008;3:S29-S37.
ABSTRACT | FULL TEXT  

Renal and cardiac effects of antihypertensive treatment with ramipril versus metoprolol in autosomal dominant polycystic kidney disease
Steinman
Nephrol Dial Transplant 2008;23:431-433.
FULL TEXT  

The Canadian ACE-inhibitor trial to improve renal outcomes and patient survival in kidney transplantation study design
Knoll et al.
Nephrol Dial Transplant 2008;23:354-358.
ABSTRACT | FULL TEXT  

Clinical research of kidney diseases 1: researchable questions and valid answers
Ravani et al.
Nephrol Dial Transplant 2007;22:3681-3690.
FULL TEXT  

Chronic Kidney Disease, Cardiovascular Events, and the Effects of Perindopril-Based Blood Pressure Lowering: Data from the PROGRESS Study
Perkovic et al.
J. Am. Soc. Nephrol. 2007;18:2766-2772.
ABSTRACT | FULL TEXT  

Clinical research of kidney diseases 1: researchable questions and valid answers
Ravani et al.
Nephrol Dial Transplant 2007;22:2459-2468.
FULL TEXT  

The Intrarenal Renin-Angiotensin System: From Physiology to the Pathobiology of Hypertension and Kidney Disease
Kobori et al.
Pharmacol. Rev. 2007;59:251-287.
ABSTRACT | FULL TEXT  

2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)
Authors/Task Force Members: et al.
Eur Heart J 2007;0:ehm236v1-75.
FULL TEXT  

BiDil for Heart Failure in Black Patients: Implications of the U.S. Food and Drug Administration Approval
Bibbins-Domingo and Fernandez
ANN INTERN MED 2007;146:52-56.
ABSTRACT | FULL TEXT  

The importance of a correct evaluation of progression in studies on chronic kidney disease
Kamper
Nephrol Dial Transplant 2007;22:3-5.
FULL TEXT  

The Cardiovascular Disease Continuum Validated: Clinical Evidence of Improved Patient Outcomes: Part II: Clinical Trial Evidence (Acute Coronary Syndromes Through Renal Disease) and Future Directions
Dzau et al.
Circulation 2006;114:2871-2891.
FULL TEXT  

Improvements in clinical outcomes with the use of angiotensin-converting enzyme inhibitors: cross-fertilization between clinical and basic investigation
Pfeffer and Frohlich
Am. J. Physiol. Heart Circ. Physiol. 2006;291:H2021-H2025.
ABSTRACT | FULL TEXT  

Baseline Predictors of Renal Disease Progression in the African American Study of Hypertension and Kidney Disease
Norris et al.
J. Am. Soc. Nephrol. 2006;17:2928-2936.
ABSTRACT | FULL TEXT  

Validation of Creatinine-Based Estimates of GFR When Evaluating Risk Factors in Longitudinal Studies of Kidney Disease
Wang et al.
J. Am. Soc. Nephrol. 2006;17:2900-2909.
ABSTRACT | FULL TEXT  

Progression of renal disease--can we forget about inhibition of the renin-angiotensin system?
Mann et al.
Nephrol Dial Transplant 2006;21:2348-2351.
FULL TEXT  

Blood Pressure Reduction Is Not the Only Determinant of Outcome
Sever et al.
Circulation 2006;113:2754-2774.
FULL TEXT  

Biomarkers of Cardiovascular Disease: Molecular Basis and Practical Considerations
Vasan
Circulation 2006;113:2335-2362.
FULL TEXT  

Differing effects of antihypertensive drugs on the incidence of diabetes mellitus among patients with hypertensive kidney disease.
Thornley-Brown et al.
Arch Intern Med 2006;166:797-805.
ABSTRACT | FULL TEXT  

Kidney Function and Mortality among Patients with Left Ventricular Systolic Dysfunction
Khan et al.
J. Am. Soc. Nephrol. 2006;17:244-253.
ABSTRACT | FULL TEXT  

Importance of Race/Ethnicity in Clinical Trials: Lessons From the African-American Heart Failure Trial (A-HeFT), the African-American Study of Kidney Disease and Hypertension (AASK), and the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)
Taylor et al.
Circulation 2005;112:3654-3666.
FULL TEXT  

Differential Effects of {beta}-Blockers on Albuminuria in Patients With Type 2 Diabetes
Bakris et al.
Hypertension 2005;46:1309-1315.
ABSTRACT | FULL TEXT  

Additional Information
JAMA 2005;294:E1-E3.
FULL TEXT  

Direct, Progressive Association of Cardiovascular Risk Factors With Incident Proteinuria: Results From the Korea Medical Insurance Corporation (KMIC) Study
Jee et al.
Arch Intern Med 2005;165:2299-2304.
ABSTRACT | FULL TEXT  

A Noninferiority Comparison of Valsartan/Hydrochlorothiazide Combination Versus Amlodipine in Black Hypertensives
Weir et al.
Hypertension 2005;46:508-513.
ABSTRACT | FULL TEXT  

Essential Hypertension, Progressive Renal Disease, and Uric Acid: A Pathogenetic Link?
Johnson et al.
J. Am. Soc. Nephrol. 2005;16:1909-1919.
ABSTRACT | FULL TEXT  

Blood Pressure Control, Drug Therapy, and Kidney Disease
Contreras et al.
Hypertension 2005;46:44-50.
ABSTRACT | FULL TEXT  

Renal Outcomes in High-Risk Hypertensive Patients Treated With an Angiotensin-Converting Enzyme Inhibitor or a Calcium Channel Blocker vs a Diuretic: A Report From the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)
Rahman et al.
Arch Intern Med 2005;165:936-946.
ABSTRACT | FULL TEXT  

The Relationship Between Magnitude of Proteinuria Reduction and Risk of End-stage Renal Disease: Results of the African American Study of Kidney Disease and Hypertension
Lea et al.
Arch Intern Med 2005;165:947-953.
ABSTRACT | FULL TEXT  

Slowing Progression Along the Renal Disease Continuum
Kopyt
JAOA: Journal of the American Osteopathic Association 2005;105:207-215.
ABSTRACT | FULL TEXT  

A Comparison of Iothalamate-GFR and Serum Creatinine-Based Outcomes: Acceleration in the Rate of GFR Decline in the African American Study of Kidney Disease and Hypertension
Lewis et al.
J. Am. Soc. Nephrol. 2004;15:3175-3183.
ABSTRACT | FULL TEXT  

Systematic Review: Antihypertensive Drug Therapy in Black Patients
Brewster et al.
ANN INTERN MED 2004;141:614-627.
ABSTRACT | FULL TEXT  

Detection of Chronic Kidney Disease With Laboratory Reporting of Estimated Glomerular Filtration Rate and an Educational Program
Akbari et al.
Arch Intern Med 2004;164:1788-1792.
ABSTRACT | FULL TEXT  

Surrogate Markers for Cardiovascular Disease: Functional Markers
Cohn et al.
Circulation 2004;109:IV-31-IV-46.
FULL TEXT  

Development Of Chronic Kidney Disease and Cardiovascular Prognosis in Essential Hypertensive Patients
Segura et al.
J. Am. Soc. Nephrol. 2004;15:1616-1622.
ABSTRACT | FULL TEXT  

Combined Blockade of the Renin-Angiotensin System With Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Type 1 Receptor Antagonists
Azizi and Menard
Circulation 2004;109:2492-2499.
FULL TEXT  

Blood Pressure Control and Nephroprotection in Diabetes
Abbott et al.
J Clin Pharmacol 2004;44:431-438.
ABSTRACT | FULL TEXT  

Urinary Potassium Excretion and Sodium Sensitivity in Blacks
Aviv et al.
Hypertension 2004;43:707-713.
ABSTRACT | FULL TEXT  

Cardiovascular risk reduction in hypertensive black patients with left ventricular hypertrophy: The life study
Julius et al.
J Am Coll Cardiol 2004;43:1047-1055.
ABSTRACT | FULL TEXT  

Angiotensin-Converting Enzyme Inhibitors versus AT1 Receptor Antagonist in Cardiovascular and Renal Protection: The case for AT1 Receptor Antagonist
Berl
J. Am. Soc. Nephrol. 2004;15:S71-76.
ABSTRACT | FULL TEXT  

Screening for Proteinuria in US Adults: A Cost-effectiveness Analysis
Boulware et al.
JAMA 2003;290:3101-3114.
ABSTRACT | FULL TEXT  

Risk Factors for Chronic Kidney Disease: A Prospective Study of 23,534 Men and Women in Washington County, Maryland
Haroun et al.
J. Am. Soc. Nephrol. 2003;14:2934-2941.
ABSTRACT | FULL TEXT  

Vasopeptidase inhibition prevents nephropathy in Zucker diabetic fatty rats
Schafer et al.
Cardiovasc Res 2003;60:447-454.
ABSTRACT | FULL TEXT  

Effects of Blood Pressure Level on Progression of Diabetic Nephropathy: Results From the RENAAL Study
Bakris et al.
Arch Intern Med 2003;163:1555-1565.
ABSTRACT | FULL TEXT  

National Kidney Disease Education Program
Hostetter and Lising
J. Am. Soc. Nephrol. 2003;14:S114-116.
ABSTRACT | FULL TEXT  

The Rationale and Design of the AASK Cohort Study
Appel et al.
J. Am. Soc. Nephrol. 2003;14:S166-172.
ABSTRACT | FULL TEXT  

Progression of Chronic Renal Failure
Yu
Arch Intern Med 2003;163:1417-1429.
ABSTRACT | FULL TEXT  

Results of ALLHAT: Is This the Final Answer Regarding Initial Antihypertensive Drug Therapy?
Moser
Arch Intern Med 2003;163:1269-1273.
FULL TEXT  

Health Outcomes Associated With Various Antihypertensive Therapies Used as First-Line Agents: A Network Meta-analysis
Psaty et al.
JAMA 2003;289:2534-2544.
ABSTRACT | FULL TEXT  

Diabetic Nephropathy in Type 2 Diabetes Prevention and Patient Management
Wolf and Ritz
J. Am. Soc. Nephrol. 2003;14:1396-1405.
FULL TEXT  

Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT): Practical Implications
Oparil
Hypertension 2003;41:1006-1009.
FULL TEXT  

Principal Results of the Controlled Onset Verapamil Investigation of Cardiovascular End Points (CONVINCE) Trial
Black et al.
JAMA 2003;289:2073-2082.
ABSTRACT | FULL TEXT  

Management of High Blood Pressure in African Americans: Consensus Statement of the Hypertension in African Americans Working Group of the International Society on Hypertension in Blacks
Douglas et al.
Arch Intern Med 2003;163:525-541.
FULL TEXT  

Antihypertensive Drugs and Renal Protection
Fukuda et al.
JAMA 2003;289:1102-1103.
FULL TEXT  

Outcome beyond blood pressure control?
Staessen et al.
Eur Heart J 2003;24:504-514.
FULL TEXT  

Cardiovascular Disease in Type 2 Diabetes Mellitus: Current Management Guidelines
Mooradian
Arch Intern Med 2003;163:33-40.
ABSTRACT | FULL TEXT  

Preventing stroke with ramipril---authors' reply
Yusuf et al.
BMJ 2003;326:52-52.
FULL TEXT  

Major Outcomes in High-Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)
The ALLHAT Officers and Coordinators for the ALLHA
JAMA 2002;288:2981-2997.
ABSTRACT | FULL TEXT  

Effect of Blood Pressure Lowering and Antihypertensive Drug Class on Progression of Hypertensive Kidney Disease: Results From the AASK Trial
Wright et al.
JAMA 2002;288:2421-2431.
ABSTRACT | FULL TEXT  

Hypertension Control and Kidney Disease: Some Questions Answered, Many Remain
Alderman
JAMA 2002;288:2466-2467.
FULL TEXT  

Time Trends in High Blood Pressure Control and the Use of Antihypertensive Medications in Older Adults: The Cardiovascular Health Study
Psaty et al.
Arch Intern Med 2002;162:2325-2332.
ABSTRACT | FULL TEXT  

Nondiabetic Kidney Disease
Levey
NEJM 2002;347:1505-1511.
FULL TEXT  

Halting progression of renal failure: consideration beyond angiotensin II inhibition
Salahudeen
Nephrol Dial Transplant 2002;17:1871-1875.
FULL TEXT  

Renal Dysfunction Complicating the Treatment of Hypertension
Palmer
NEJM 2002;347:1256-1261.
FULL TEXT  

Update in General Internal Medicine
Lucey and Cole
ANN INTERN MED 2002;137:334-340.
FULL TEXT  

Bruce Psaty and the risks of calcium channel blockers
Deyo
Qual Saf Health Care 2002;11:294-296.
FULL TEXT  

Guest Editorial: What Is the Appropriate Treatment of Hypertension in Elders?
Aronow
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2002;57:M483-486.
FULL TEXT  

Efficacy of angiotensin-converting enzyme inhibition in reducing progression from asymptomatic left ventricular dysfunction to symptomatic heart failure in black and white patients
Dries et al.
J Am Coll Cardiol 2002;40:311-317.
ABSTRACT | FULL TEXT  

Review: Calcium channel blockade in combination with angiotensin-converting enzyme inhibition or angiotensin II (AT1-receptor) antagonism in hypertensive diabetics and patients with renal disease and hypertension
Swales and Williams
Journal of Renin-Angiotensin-Aldosterone System 2002;3:79-89.
ABSTRACT  

Evaluation and Treatment of Patients With Systemic Hypertension
Garg et al.
Circulation 2002;105:2458-2461.
FULL TEXT  

Nephropathy in Patients with Type 2 Diabetes
Remuzzi et al.
NEJM 2002;346:1145-1151.
FULL TEXT  

Randomized controlled crossover study of the effect on proteinuria and blood pressure of adding an angiotensin II receptor antagonist to an angiotensin converting enzyme inhibitor in normotensive patients with chronic renal disease and proteinuria
Kincaid-Smith et al.
Nephrol Dial Transplant 2002;17:597-601.
ABSTRACT | FULL TEXT