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Treating Hypertension Doesn't Halt Chronic Kidney Disease

In black patients, disease still progresses despite low blood pressure goal

WEDNESDAY, April 30 (HealthDay News) -- Chronic kidney disease in hypertensive black patients will still continue to progress when treated with antihypertensive and renin-angiotensin system-blocking therapy, according to research published in the April 28 issue of the Archives of Internal Medicine.

Lawrence J. Appel, M.D., of the Johns Hopkins Institutions in Baltimore, and colleagues conducted a cohort study of 1,094 black patients with hypertensive renal disease who had participated in a randomized trial to test three initial antihypertensive drugs -- angiotensin-converting enzyme inhibitors, calcium channel blockers and β-blockers -- and either usual or low blood pressure control. The trial ran from 1995 to 2001 and the cohort study was conducted from 2002 to 2007.

During the trial, use of angiotensin-converting enzyme inhibitors or an angiotensin receptor blocker ranged from 38.5 percent to 49.8 percent, but in each year of the cohort study, use of the drugs ranged from 83.7 percent to 89 percent, the researchers report. Mean blood pressure was 136/82 mm Hg in the trial and 133/78 mm Hg in the cohort study. The 10-year cumulative incidence rate of progression of kidney disease was 53.9 percent, the report indicates.

"These results highlight the importance of preventing initial kidney damage, the critical need to identify modifiable risk factors, and the requirement to test promising therapies at the earliest stages of chronic kidney disease," the authors write.

Several of the study authors report financial relationships with the pharmaceutical industry.

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