Lessons from the African-American study of kidney disease and hypertension: An update

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Hypertension is the second leading attributable cause of end-stage renal disease in the United States today. The African-American Study of Kidney Disease and Hypertension was a randomized, double-blind, controlled trial designed to determine whether strict blood pressure (BP) control, angiotensin-converting enzyme inhibitor (ACEI)-based, or calcium channel blocker (CCB)-based regimens were superior to less strict BP control and β-blocker (BB)-based regimens, respectively. The study enrolled 1093 African Americans with hypertensive nephrosclerosis and followed them for 4 years with repeated direct measurement of glomerular filtration rate (GFR) and monitoring of end points, including rapid decline in GFR, end-stage kidney disease, and death. From this landmark study, we learned that strict BP control is achievable in this study population, but it did not slow progression of kidney disease, and we learned that an ACEI-based therapy was superior to either a BB- or CCB-based regimen. In addition, we learned that proteinuria is the most important predictor of progression of kidney disease; ACEI and CCB have differential effects on proteinuria; and a CCB-based regimen combined with strict BP control may be the next best choice to an ACEI-based regimen in this population.

Original languageEnglish (US)
Pages (from-to)409-412
Number of pages4
JournalCurrent Hypertension Reports
Volume8
Issue number5
DOIs
StatePublished - Oct 2006

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Calcium Channel Blockers
Kidney Diseases
Angiotensin-Converting Enzyme Inhibitors
African Americans
Blood Pressure
Hypertension
Glomerular Filtration Rate
Proteinuria
Chronic Kidney Failure
Nephrosclerosis
Population
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Lessons from the African-American study of kidney disease and hypertension : An update. / Toto, Robert D.

In: Current Hypertension Reports, Vol. 8, No. 5, 10.2006, p. 409-412.

Research output: Contribution to journalArticle

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