July 1, 2001Journal of Clinical HypertensionOpen Access

The African American Study of Kidney Disease and Hypertension (AASK): New Findings

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Why the study?

Does ramipril improve renal outcomes compared to amlodipine in African Americans with hypertensive nephrosclerosis?

Population

1,094 self-identified African Americans with hypertension, aged 18-70 years, nondiabetic, with mild to…

Comparison

Ramipril 2.5-10 mg/day targeted to usual or low… vs Amlodipine 5-10 mg/day targeted to usual or low…

Design

Review, uneven block design with a 2:2:1 ratio for…

Follow-up

median 36 to 37 months

Authors

DSDomenic A. SicaPreventive Cardiology JDJanice G. DouglasUniversity Hospitals of Cleveland

Discussion

Member takes

Implication

May support ACEI preference for renoprotection in this population; leaves open confirmation in prospective trials.

Structured PICO

Does ramipril improve renal outcomes compared to amlodipine in African Americans with hypertensive nephrosclerosis?

Population

1,094 self-identified African Americans with hypertension, aged 18-70 years, nondiabetic, with mild to moderate renal insufficiency (GFR 20-65 ml/min/1.73 m2) and urinary protein to creatinine ratio <2.5.

Intervention

Ramipril 2.5-10 mg/day (ACE inhibitor) targeted to usual (102-107 mm Hg) or low (<92 mm Hg) mean arterial pressure.

Comparator

Amlodipine 5-10 mg/day (dihydropyridine calcium channel blocker) targeted to usual or low mean arterial pressure.

Outcome

Rate of change of GFR (GFR slope) and a clinical composite of confirmed reduction in GFR by 50% or 25 ml/min, ESRD, or death.composite

In African Americans with hypertensive nephrosclerosis, ramipril provides superior renoprotection and slows disease progression compared to amlodipine.

Limitations

AASK study was not designed to determine if the increase in GFR after starting a DHP-CCB conferred benefit on long-term renal outcome
not mechanism-oriented

Cite This Study

Sica et al. (2001) studied this question.

synapsesocial.com/papers/6a9163559ea92d4f71f07f1c https://doi.org/10.1111/j.1524-6175.2001.00474.x

Topics

Hypertension management

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The African American Study of Kidney Disease and Hypertension (AASK): New Findings

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Topics

The African American Study of Kidney Disease and Hypertension (AASK): New Findings

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider