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Hypertension Control and Kidney Disease
Some Questions Answered, Many Remain
Michael H. Alderman, MD
JAMA. 2002;288:2466-2467.
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The African American Study of Kidney Disease and Hypertension (AASK) compared renal outcomes at different blood pressure goals with alternate antihypertensive drugs in patients with hypertensive nephrosclerosis. The primary end point was change in the glomerular filtration rate (GFR) with a secondary clinical composite end point composed of end-stage renal disease (ESRD), a threshold decline in GFR, and all-cause mortality. The results of this trial, reported in this issue of THE JOURNAL, are unlikely to satisfy physicians caring for patients like those in AASK.1
Therapeutic guidelines now recommend blood pressure reduction to 130/85 mm Hg in patients with hypertension and renal insufficiency and to 125/75 mm Hg for those with proteinuria of more than 1 g per 24 hours.2 The AASK was conceived as an experimental response to the virtual absence of data in support of such a recommendation, a recognition of the disproportionate burden of . . . [Full Text of this Article]
Author Affiliation: Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, NY.
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H. T. Ong
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EXTRACT
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RELATED ARTICLE
Effect of Blood Pressure Lowering and Antihypertensive Drug Class on Progression of Hypertensive Kidney Disease: Results From the AASK Trial
Jackson T. Wright, Jr, George Bakris, Tom Greene, Larry Y. Agodoa, Lawrence J. Appel, Jeanne Charleston, DeAnna Cheek, Janice G. Douglas-Baltimore, Jennifer Gassman, Richard Glassock, Lee Hebert, Kenneth Jamerson, Julia Lewis, Robert A. Phillips, Robert D. Toto, John P. Middleton, Stephen G. Rostand, and for the African American Study of Kidney Disease and Hypertension Study Group
JAMA. 2002;288(19):2421-2431.
ABSTRACT
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Long-term Cardiovascular Consequences of Diuretics vs Calcium Channel Blockers vs Angiotensin-Converting Enzyme Inhibitors
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