Choice of Drugs for Black Patients with Hypertensive Renal Disease

In a randomized trial comparing ramipril, metoprolol, and amlodipine in self-identified African-American patients with hypertensive renal disease, investigators prematurely halted the amlodipine arm, because this group experienced a higher rate of adverse clinical events and a steeper decline in glomerular filtration rate (GFR) when heavy proteinuria was present than did members of the other 2 arms (Journal Watch Jul 17 2001). Now, the researchers report final results of the trial, which involved 1094 patients with mean baseline blood pressure of about 150/96 mm Hg and mean GFR of 46 mL/min/1.73 m². Many patients required second or third drugs for BP control.

The authors conclude that there were no definitive differences between the 3 drugs …