Document Detail


Successful blood pressure control in the African American Study of Kidney Disease and Hypertension.
MedLine Citation:
PMID:  12123409     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The African American Study of Kidney Disease and Hypertension (AASK) is an ongoing trial to evaluate the effect of blood pressure and choice of antihypertensive drug on the rate of decline of renal function. OBJECTIVE: To present the success of the AASK in achieving the trial's rigorous blood pressure goals in an extremely challenging patient population. METHODS: The AASK participants included African American patients with hypertension (n = 1094), aged 18 to 70 years, with glomerular filtration rates between 20 and 65 mL/min per 1.73 m(2) and no other identified causes of renal insufficiency. Participants were randomized to a goal mean arterial blood pressure (MAP) of either 102 to 107 mm Hg (usual MAP goal) or 92 mm Hg or less (low MAP goal). Participants in each of these groups were also randomized (double-blind) to a regimen containing metoprolol succinate, ramipril, or amlodipine besylate. Additional agents were added, if required, in the following recommended order: furosemide, doxazosin mesylate, clonidine hydrochloride, or hydralazine hydrochloride (or minoxidil, if needed). RESULTS: In participants randomized to the low MAP goal, the percentage of participants who achieved a blood pressure of less than 140/90 mm Hg increased from a baseline of 20.0% to 78.9% by 14 months after randomization. For usual MAP goal participants, the corresponding percentages increased from 21.5% to 41.8%. The difference in median levels of MAP between the 2 MAP goal groups increased and remained at approximately 12 mm Hg. Blood pressure reduction was similar regardless of age, sex, body mass index, education, insurance or employment status, income, or marital status. CONCLUSION: The blood pressure goals set and achieved in AASK participants clearly demonstrate that adequate blood pressure control can be achieved even in hypertensive populations whose blood pressure is the most difficult to control.
Authors:
Jackson T Wright; Lawrence Agodoa; Gabriel Contreras; Tom Greene; Janice G Douglas; James Lash; Otelio Randall; Nancy Rogers; Michael C Smith; Shaul Massry;
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Evaluation Studies; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Archives of internal medicine     Volume:  162     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-18     Completed Date:  2002-08-14     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1636-43     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Division of Hypertension, Case Western Reserve University, 10900 Euclid Ave, Wood Bldg, Room W-165, Cleveland, OH 44106-4982, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
African Continental Ancestry Group*
Aged
Antihypertensive Agents / therapeutic use
Blood Pressure / drug effects,  physiology*
Cohort Studies
Double-Blind Method
Female
Follow-Up Studies
Glomerular Filtration Rate / drug effects,  physiology
Humans
Hypertension / complications*,  drug therapy,  physiopathology*
Kidney Diseases / complications*,  drug therapy,  physiopathology*
Male
Middle Aged
Grant Support
ID/Acronym/Agency:
2P20 RR11104/RR/NCRR NIH HHS; 5M01 RR-00071/RR/NCRR NIH HHS; M01 00032//PHS HHS; M01 RR-00080/RR/NCRR NIH HHS; M01 RR00827/RR/NCRR NIH HHS; P20-RR11145/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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