Preventing renal dysfunction in patients with hypertension: clinical implications from the early AASK Trial results.
Strategies to delay progression of established renal disease have primarily been directed at examining the class of antihypertensive therapy and/or the level of blood pressure control. In diabetic renal disease many trials have noted a protective role of ACE inhibitor-based therapy over non-ACE inhibitor-based therapy. This paper reviews recent clinical trials evaluating hypertension-related kidney disease including the interim results of the African-American Study of Kidney Diseases and Hypertension (AASK) Study, to date the largest prospective study of African-American patients with kidney disease due to hypertension. This trial reports a renoprotective effect of ACE inhibitor-based therapy over calcium-channel antagonist- based therapy. The renoprotective effect of ACE inhibitor-based therapy may, in part, be due to their antiproteinuric effect independent of blood pressure lowering.
Lea
Janice P
JP
Emory University School of Medicine, Atlanta, GA, USA. jlea@emory.edu
Brown
Denyse T
DT
Lipkowitz
Michael
M
Middleton
John
J
Norris
Keith
K
D001741:Black or African American; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003928:Diabetic Nephropathies / Q000517:prevention & control; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007674:Kidney Diseases / Q000517:prevention & control*; D011507:Proteinuria / Q000517:prevention & control
D000806:Angiotensin-Converting Enzyme Inhibitors