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The incidence of end-stage renal disease (ESRD) secondary to hypertension has increased steadily among African Americans during the past 2 decades. Although ACE inhibitors have been shown to slow renal-disease progression in patients with diabetes and proteinuria (JWC Sep 1997, p. 74, accession number 970818008, and Lancet 1997; 349:1857), the effect on African Americans is not known.
This was an interim analysis of the African American Study of Kidney Disease and Hypertension: a 3x2-factorial, randomized, double-blind trial involving 1094 African Americans (age range, 18 to 70) with hypertensive renal disease. Subjects were randomized to 1 of 2 mean arterial blood-pressure goals and to 1 of 3 drug regimens: ramipril (2.5 to 10 mg/day), amlo…