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Steven J. Rosansky, MD
William Jennings Bryan Dorn Veterans' Hospital Columbia, SC

JAMA. 1993;269(23):2983.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—The article by Perneger et al¹ on the effect of increased blood pressure on kidney function supports the conclusion that we reached in a previous study. In our study,² "time averaged blood pressures" (clinic blood pressures recorded quarterly for a mean period of approximately 10 years) in a hypertensive group and a normotensive control group predicted change in serum creatinine levels.

Several methodological issues are relevant to both studies. First, since hypertension may occur as a consequence of renal damage, it might be more useful to look at blood pressure levels measured prior to a change in renal function (as in the study by Perneger et al) instead of blood pressure levels measured during the follow-up period, as we used. Nevertheless, because of the unreliability of single blood pressure measurements, it may be necessary to obtain several baseline blood pressure values to see their effect . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Deputy Editor (West), and Margaret A. Winker, MD, Senior Editor.

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