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New study shows benefit of lowering blood pressure for African Americans with chronic kidney disease

African-Americans suffering from chronic kidney disease (CKD) who show evidence of protein in their urine may benefit from a lower blood pressure standard, according to a study by the African-American Study of Kidney Disease and Hypertension (AASK), a consortium of 22 medical centers in the United Sates including clinical scientists at the University of Massachusetts Medical School and UMass Memorial Medical Center.

The study, funded by the National Institutes of Health, appears in the Sept. 2 issue of the New England Journal of Medicine.

The AASK study found that among African-Americans with protein in their urine, setting a blood pressure goal at a lower level, roughly 130/80 mmHg instead of the standard 140/90 mmHg, reduced the likelihood of kidney disease progression, kidney failure or death by 27 percent.

“Chronic kidney disease is a major and growing public health problem,” said Robert A. Phillips, MD, PhD, professor of medicine at the University of Massachusetts Medical School and director of the Heart and Vascular Center of Excellence at UMass Memorial Medical Center. “Rigorous, long-term studies, such as the AASK, provide new insights into the treatment of diseases that progress over years and which would otherwise be impossible to identify. In this study, we learned that a more intensive blood pressure control may be an important approach to preventing kidney disease progression.”

This information may encourage physicians treating patients with CKD to use evidence-based, personalized medicine, allowing them to tailor a treatment regiment to each patient’s unique characteristics. “AASK provides the strongest evidence to date that a lower blood pressure goal may be beneficial, in terms of preventing kidney disease progression,” said Phillips, who is also director of the Cardiovascular Core Laboratories for the AASK and is a member of the study’s executive committee. “Physicians treating African Americans with chronic kidney disease should monitor their patients’ urine for protein and consider a lower blood pressure goal.”

The AASK trial and the follow-up study were conducted at 22 U.S. medical centers and were funded by the National Institute on Minority Health and Health Disparities beginning in 1994. Additional support was provided by the NIH’s National Institute on Minority Health and Health Disparities, King Pharmaceuticals and other pharmaceutical companies that donated study drugs.

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